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Sample records for ct-guided needle biopsy

  1. CT guided percutaneous needle biopsy of the chest: initial experience

    African Journals Online (AJOL)

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

  2. CT-guided core-needle biopsy in omental pathology

    International Nuclear Information System (INIS)

    Pombo, F.; Rodriguez, E.; Martin, R.; Lago, M.

    1997-01-01

    Purpose: To assess the accuracy and clinical usefulness of CT-guided core-needle biopsy in the diagnosis of omental pathology. Material and Methods: We retrospectively reviewed the results of CT-guided percutaneous core biopsies in 25 patients with focal (n=2) or diffuse (n=23) omental pathology. These results were compared to the final diagnoses as determined by laparotomy (n=15), laparoscopic biopsy (n=3), endoscopic biopsy (n=1), or by the results of percutaneous biopsy and clinical-radiological and bacteriological modalities (n=6). The final diagnoses showed 4 patients with isolated omental pathology and 21 with widespread peritoneal involvement. The CT-guided biopsies were performed with 1.0=1.8-mm Surecut core-needles. Results: In 16 patients, the final diagnosis was metastatic adenocarcinoma - with the primary tumor sites in the ovary (n=3), stomach (n=1), appendix (n=2), and unknown (n=10). In the remaining 9 patients, the final diagnosis was hepatocellular carcinoma, lymphoma, and mesothelioma in 1 patient each; tuberculosis in 5; and actinomycosis in 1. Sufficient histological (n=16) or cytological (n=8) material was obtained by CT biopsy in 24/25 (96%) cases; the specimen was insufficient for diagnosis in 1 case. In differentiating benign from malignant disease, CT-guided biopsy showed a sensitivity, specificity and accuracy of respectively 89.5%, 100% and 92%. It gave a specific diagnosis in 78.9% (15/19) of patients with malignant conditions and in 50% (3/6) of patients with benign disorders. There were no biopsy-related complications. Conclusion: CT-guided percutaneous core-needle biopsy of the omentum is a safe, useful and highly accurate procedure for diagnosing malignant omental pathology. (orig.)

  3. CT guided fine needle aspiration biopsy of biliopancreatic lesions

    International Nuclear Information System (INIS)

    Geng, Jia-Zheng; Qin, Pan-Rui; Hui, Liu-De; Po, Pei-Dong

    1987-01-01

    CT guided percutaneous fine needle aspiration biopsy was performed on 30 patients with pancreatic and periampullary neoplasms, in the Department of Surgery, China-Japan Friendship Hospital, between March 1985 and January 1986. We obtained positive cytodiagnosis from all cases of carcinoma of the pancreatic head (9 cases), body and tail (4 cases), and ampullary carcinomas (5 cases) (100 per cent). In 2 of 3 duodenal carcinomas (66.6 per cent), and 6 of 7 distal common duct carcinomas (86 per cent), a positive cytodiagnosis was also obtained. On the other hand, 2 cases of pancreatitis both gave a negative cytodiagnosis, i.e. no false positives were obtained. Out of the 30 cases who underwent CT guided biopsy, a correct diagnosis was obtained in 28, i.e. a diagnostic accuracy of 93.3 per cent. The cytodiagnosis of the other two cases was either suspicious or false negative. There have been no clinical complications noted. (author)

  4. Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions

    International Nuclear Information System (INIS)

    Hryhorczuk, Anastasia L.; Strouse, Peter J.; Biermann, J.S.

    2011-01-01

    CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies. To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign. From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed. Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies. Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions. (orig.)

  5. Clinical Value of CT-Guided Needle Biopsy for Retroperitoneal Lesions

    International Nuclear Information System (INIS)

    Tomozawa, Yuki; Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kato, Mina; Kanamoto, Takaaki; Sakane, Makoto

    2011-01-01

    The purpose of this study was to investigate retrospectively the clinical procedural performance of CT-guided needle biopsy for retroperitoneal lesions. CT-guided needle biopsy was performed in 74 consecutive patients (M:F = 44:30; mean age, 59.7 years) with retroperitoneal lesions between April 1998 and June 2009. The target lesion ranged from 1.5 to 12.5 cm in size. The biopsy access path ranged from 3.5 to 11.5 cm in depth. A biopsy specimen was obtained using an 18-gauge core needle under a CT or CT-fluoroscopy guidance and with the patient under local anesthesia. The histopathological diagnoses from the biopsies were obtained. The diagnostic confirmation of the subtype of lymphoma was evaluated. Satisfactory biopsy samples were obtained in 73 (99%) of 74 patients and a pathological diagnosis was made in 70 (95%) of 74 patients. Sixty three lesions were malignant (45 lymphomas, nine primary tumors, nine lymph node metastases) and seven were benign. The subtype of lymphoma was specified in 43 (96%) of 45 patients who were diagnosed with lymphoma. Analysis of the value of CT-guided biopsy in this series indicated 63 true positives, zero false positive, six true negatives and five false negatives. This test had a sensitivity of 93%, a specificity of 100% and an accuracy of 93%. No major complications were seen and minor complications were noted in seven patients (five with local hematomas, two with transient pain at the puncture site). CT-guided needle biopsy for retroperitoneal lesions is highly practical and useful, and particularly for determining the subtypes in patients with lymphoma.

  6. Diagnosis of mediastinal neoplasms using mediastinoscopy and CT-guided needle biopsy supported by gene analysis

    International Nuclear Information System (INIS)

    Chiba, Wataru; Sawai, Satoru; Ishida, Hisao; Hanawa, Takeshi; Matsubara, Yoshito; Ikeda, Sadao; Kinoshita, Moritoshi; Ikei, Nobuhiro.

    1993-01-01

    Of 140 cases of mediastinal neoplasms in our hospital, histological diagnosis was confirmed in 129 cases. We examined the methods of preoperative biopsy with those 129 cases. Biopsy had been performed in 25 cases. Mediastinoscopy was performed in seven cases, needle biopsy in eight cases, lymph node biopsy in eight cases, esophageal biopsy using a gastrofiberscope in one case, transbronchial biopsy using a bronchoscope in one case. The true positive rates of those methods were 100% for both mediastinoscopy and lymph node biopsy, and 75% for needle biopsy. Preoperative misdiagnosis occurred in two cases of needle biopsy. The postoperative histological diagnosis was malignant lymphoma in both cases. We performed gene analysis of the immunoglobulin heavy chain gene, light chain κ and λ genes, and the T-cell receptor β gene by use of biopsied specimens, and we found rearrangement bands of these genes in the cases of malignant lymphoma. Therefore, we summarize that gene analysis is a reliable method if malignant lymphoma is suspected. If a needle biopsy is performed under CT guidance, the needle is sure to puncture the tumor. We concluded, therefore, that if a tumor is located in the anterior mediastinum, CT-guided needle biopsy should be performed first of all. Mediastinoscopy is a useful method if the tumor is located in the mid-mediastinum. (author)

  7. Usefulness of normal saline for sealing the needle track after CT-guided lung biopsy

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

    2015-01-01

    Aim: To determine whether the use of normal saline for sealing the needle track can reduce the incidence of pneumothorax and chest tube placement after computed tomography (CT)-guided lung biopsy. Materials and methods: A prospective, randomised, controlled trial enrolling 322 patients was conducted. All patients were randomly assigned to one of two groups: those in whom the needle track was not sealed with normal saline (n=161, Group A) and those who did receive normal saline (n=161, Group B). CT-guided biopsy was performed with coaxial technique. Normal saline, which ranged from 1–3 ml, was injected while the trocar needle was being withdrawn. Patient characteristics, lesion, and procedure variables were analysed as potential risk variables for occurrence of pneumothorax and chest tube placement. Results: The incidence of pneumothorax was 26.1% in Group A and 6.2% in Group B (p<0.001). Nine patients in Group A and one patient in Group B required chest tube placement (p=0.010). Using multiple logistic regression analysis, smaller lesion size, greater needle–pleural angle, longer lesion–pleural distance, presence of emphysema, and no sealing the needle track with normal saline were significantly associated with an increased risk of pneumothorax, and that the latter three factors were also associated with an increased risk of pneumothorax requiring chest tube placement. Conlusion: Normal saline for sealing the needle track significantly reduces the incidence of pneumothorax and prevents subsequent chest tube placement after CT-guided lung biopsy. - Highlights: • Normal saline is an effective sealant for use in lung biopsy. • This technique reduced the incidence of pneumothorax and chest tube placement. • This technique should be recommended for CT-guided lung biopsy.

  8. The diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions

    International Nuclear Information System (INIS)

    Wang Hui; Zhang Fuchen; Ji Hongjian; Chen Liping

    2009-01-01

    Objective: To evaluate the diagnostic significance of CT-guided percutaneous transthoracic cutting needle biopsy for pulmonary lesions. Methods: The clinical data of CT-guided transthoracic cutting needle biopsy in 436 patients performed in past 10 years were retrospectively analyzed. Of 436 cases with pulmonary lesions, primary lung cancer was confirmed in 341, pulmonary metastasis in 62, non-malignant lesions in 33. The diagnostic accuracy and sensitivity were statistically analyzed. The occurrence of complications was discussed. Results: The diagnostic accuracy rate and sensitivity rate in primary lung cancer group were 94.7% and 94.1% respectively, in pulmonary metastasis group were 58.2% and 51.6% respectively and in non-malignant lesions group were 57.6% and 57.6% respectively. The successful rate of biopsy was 97.9%. The occurrence of complications was 15.6%. Conclusion: CT-guided percutaneous transthoracic cutting needle biopsy is a safe and valuable diagnostic technique with high diagnostic accuracy and less complications. It is very helpful in confirming the diagnosis in the patients with suspected primary pulmonary cancer, although the technical procedures need to be further improved for metastatic and non-malignant lung lesions. (authors)

  9. Usefulness of CT-guided trans-bronchial needle aspiration biopsy for mediastinal lymph nodes

    International Nuclear Information System (INIS)

    Cui Bing; Rong Fu

    2001-01-01

    Objective: To determine the nature of enlarged mediastinal lymph nodes, the study of CT-guided trans-bronchial needle aspiration biopsy (CT-TBNA) was conducted. Methods: According to classification and locating standard of mediastinal lymph nodes, CT-TBNA was performed in 158 mediastinal lymph nodes of 73 patients, including 54 primary lung cancer with enlarged mediastinal lymph nodes, 5 malignant lymphoma, 3 mediastinal abscess and 11 mediastinal inflammatory adenopathy. Results: CT confirmed that the needles were inside all 158 lymph nodes. Adequate aspirates for histologic and/or cytologic diagnosis were obtained in 136 of 158(86%) lymph node biopsies. No serious complications occurred. Conclusion: Locating standard of CT-guided TBNA was reliable. Puncture was safe and cost-effective. CT-TBNA was important for ascertaining the nature of mediastinal adenopathy and staging of neoplasms

  10. Factors influencing diagnostic yield of CT-guided percutaneous core needle biopsy for bone lesions

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Luo, T.Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.; Zheng, H.J.; Li, B.

    2014-01-01

    Aim: To evaluate the factors influencing diagnostic yield of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for bone lesions. Materials and methods: Between September 2005 and July 2011, 162 consecutive CT-guided CNB procedures were performed in 155 patients. The variables analysed were age, sex, lesion location, lesion type, lesion size, specimen size, biopsy needle gauge, and individual radiologist. The factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were determined by multivariate analysis of variables. Results: The diagnostic yield was 81.5%. Diagnostic yield was 89.9% for lytic bone lesions and 48.5% for sclerotic bone lesions (p < 0.001), and 89.2% for lesions ≥3 cm and 73.4% for lesions <3 cm (p = 0.010). The significant factors influencing diagnostic yield of CT-guided percutaneous CNB for bone lesions were lesion type [p < 0.001; odds ratio (OR) for a lytic lesion was approximately 12 times higher than that for a sclerotic lesion; 95% confidence interval (CI): 4.22–34.01], and lesion size (p = 0.012; OR for a lesion size ≥3 cm was about five-times higher than that for a lesion size <3 cm; 95% CI: 1.42–16.71). Conclusion: Lesion type and lesion size are determining factors in diagnostic yield. The higher diagnostic yield is correlated with lytic lesion and lesion size ≥3 cm

  11. CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsies in Japan

    International Nuclear Information System (INIS)

    Tomiyama, Noriyuki; Yasuhara, Yoshifumi; Nakajima, Yasuo; Adachi, Shuji; Arai, Yasuaki; Kusumoto, Masahiko; Eguchi, Kenji; Kuriyama, Keiko; Sakai, Fumikazu; Noguchi, Masayuki; Murata, Kiyoshi; Murayama, Sadayuki; Mochizuki, Teruhito; Mori, Kiyoshi; Yamada, Kozo

    2006-01-01

    Purpose: The aim of our study was to update the rate of severe complications following CT-guided needle biopsy in Japan via a mailed survey. Materials and methods: Postal questionnaires regarding CT-guided needle biopsy were sent out to multiple hospitals in Japan. The questions regarded: the total number and duration of CT-guided lung biopsies performed at each hospital, and the complication rates and numbers of pneumothorax, hemothorax, air embolism, tumor seeding, tension pneumothorax and other rare complications. Each severe complication was followed with additional questions. Results: Data from 9783 biopsies was collected from 124 centers. Pneumothorax was the most common complication, and occurred in 2412 (35%) of 6881 cases. A total of 39 (35%) hospitals reported 74 (0.75%) cases with severe complications. There were six cases (0.061%) with air embolism, six cases (0.061%) with tumor seeding at the site of the biopsy route, 10 cases (0.10%) with tension pneumothorax, six cases (0.061%) with severe pulmonary hemorrhage or hemoptysis, nine cases (0.092%) with hemothorax, and 27 cases (0.26%) with others, including heart arrest, shock, and respiratory arrest. From a total of 62 patients with severe complications, 54 patients (0.55%) recovered without sequela, however one patient (0.01%) recovered with hemiplegia due to cerebral infarction, and the remaining seven patients (0.07%) died. Conclusions: This is the first national study documenting severe complications with respect to CT-guided needle biopsy in Japan. The complication rate in Japan is comparable to internationally published figures. We believe this data will improve both clinicians as well as patients understanding of the risk versus benefit of CT-guided needle biopsy, resulting better decisions

  12. Diagnostic Yield of CT-Guided Percutaneous Transthoracic Needle Biopsy for Diagnosis of Anterior Mediastinal Masses.

    Science.gov (United States)

    Petranovic, Milena; Gilman, Matthew D; Muniappan, Ashok; Hasserjian, Robert P; Digumarthy, Subba R; Muse, Victorine V; Sharma, Amita; Shepard, Jo-Anne O; Wu, Carol C

    2015-10-01

    The purpose of this study was to evaluate the diagnostic yield and accuracy of CT-guided percutaneous biopsy of anterior mediastinal masses and assess prebiopsy characteristics that may help to select patients with the highest diagnostic yield. Retrospective review of all CT-guided percutaneous biopsies of the anterior mediastinum conducted at our institution from January 2003 through December 2012 was performed to collect data regarding patient demographics, imaging characteristics of biopsied masses, presence of complications, and subsequent surgical intervention or medical treatment (or both). Cytology, core biopsy pathology, and surgical pathology results were recorded. A per-patient analysis was performed using two-tailed t test, Fisher's exact test, and Pearson chi-square test. The study cohort included 52 patients (32 men, 20 women; mean age, 49 years) with mean diameter of mediastinal mass of 6.9 cm. Diagnostic yield of CT-guided percutaneous biopsy was 77% (40/52), highest for thymic neoplasms (100% [11/11]). Non-diagnostic results were seen in 12 of 52 patients (23%), primarily in patients with lymphoma (75% [9/12]). Fine-needle aspiration yielded the correct diagnosis in 31 of 52 patients (60%), and core biopsy had a diagnostic rate of 77% (36/47). None of the core biopsies were discordant with surgical pathology. There was no statistically significant difference between the diagnostic and the nondiagnostic groups in patient age, lesion size, and presence of necrosis. The complication rate was 3.8% (2/52), all small self-resolving pneumothoraces. CT-guided percutaneous biopsy is a safe diagnostic procedure with high diagnostic yield (77%) for anterior mediastinal lesions, highest for thymic neoplasms (100%), and can potentially obviate more invasive procedures.

  13. The factor analysis of the incidence of pneumothorax after CT-guided transthoracic needle aspiration biopsy

    International Nuclear Information System (INIS)

    Zhong Tao; Yu Hongguang; Wang Yong; Yang Sifu; Wang Xiaoxuan

    2007-01-01

    Objective: To analyze the impact of multiple factors on the incidence of pneumothorax associated with CT-guided transthoracic needle aspiration biopsy. Methods: The sign of pneumothorax after 162 cases (lesion diameter from 1 cm to 6 cm) CT-guided transthoracic needle aspiration biopsy was observed and its relationship with multivariate factors were analyzed by multivariate logistic regression model. Results: Thirty-two cases presented pneumothorax accounting for 19. 8%. Single variate analysis showed that the sign of pneumothorax related to intercurrent COPD, distance from lesion and chest wall, needle dwelling time and lesion diameter. 67 patients of intercurrent COPD with postoperative pneumothorax occurred in 22 cases (32.8%); With respect to those having lesions close to the chest wall (48 cases), and the cases with the distance between the chest wall and lesions less than 2 cm (55 cases) and greater than 2 cm (59 cases), the postoperative pneumothorax occurred in 0, 14 (25.5%), 18 (30.5%) cases respectively; For those patients with needle in the chest residence time of less than 10 minutes (82 cases), 10-20 minutes (51 cases), more than 20 minutes (28 cases) after the occurrence of pneumothorax were 8 (9.6%), 10(19.6%), 14 (50%) cases respectively; In contrast, those with lesion diameter less than 2 cm (65 cases), 2-4 cm(52 cases), more than 4cm(45 cases) were 19 (29.2%), 8 (15.4%) and 5 (11.1% ) respectively. The multivariate logistic regression analysis showed that the prior three factor's were risk factors of pneumothorax (OR=4.652, 4.030, 2.855 respectively). Conclusions: To avoid the pneumothorax, caution must be taken with respect to CT-guided transthoracic needle aspiration biopsy, patients with intercurrent COPD, long distance between lesion and chest wall, and smaller lesion diameter. For operation the needle dwell time within thorax should be minimized. (authors)

  14. Extrapleural paravertebral CT guided fine needle biopsy of subcarinal lymph nodes

    International Nuclear Information System (INIS)

    Tantawy, Wahid H.; El-Gemeie, Emad H.; Ibrahim, Ahmed S.; Mohamed, Mona A.

    2012-01-01

    Purpose: To report our experience in CT guided extrapleural paravertebral subcarinal lymph biopsy using a thin 25 gauge (25 G) thin needle without the need of injection of saline to widen the mediastinum. Materials and methods: Biopsy was performed using a 25 G needle which was advanced lateral to the vertebral body between the endothoracic fascia and the parietal pleura to gain access to subcarinal lymph nodes. One hundred and forty one patients were included in the study (74 females, 57 males). No artificial widening of the mediastinum using saline injection was required. The study was performed in the presence of a cytopathologist; sensitivity and specificity rates were calculated. Complications were documented for each case especially for pneumothorax and haemorrhage. Results: Cytopathological diagnosis was reached in all cases. All re-aspirations were done in the same session to reach a primary diagnosis at the time of the biopsy. Imunophenotyping study was done in 94 cases to confirm the primary diagnosis and to classify the malignant lesions. No pneumothorax was encountered. Small haematomas were noted in 5 cases (3.5%). Cytopathology showed a sensitivity of 97.2% and specificity of 100%. By adding immunophenotyping a 100% sensitivity and specificity was achieved. Conclusion: Fine needle aspiration cytology (FNAC) using a 25 gauge needle for subcarinal lymph nodes via a percutaneous extrapleural paravertebral CT guided approach is a safe, minimally invasive, and tolerable procedure yielding a high sensitivity and specificity rates without the need of artificial widening

  15. Extrapleural paravertebral CT guided fine needle biopsy of subcarinal lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Tantawy, Wahid H., E-mail: tantawyw@yahoo.com [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt); El-Gemeie, Emad H. [Pathology Department, National Cancer Institute, Fom El Khalige Faculty of Medicine, Cairo University (Egypt); Ibrahim, Ahmed S., E-mail: asibrahima@gmail.com [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt); Mohamed, Mona A. [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt)

    2012-10-15

    Purpose: To report our experience in CT guided extrapleural paravertebral subcarinal lymph biopsy using a thin 25 gauge (25 G) thin needle without the need of injection of saline to widen the mediastinum. Materials and methods: Biopsy was performed using a 25 G needle which was advanced lateral to the vertebral body between the endothoracic fascia and the parietal pleura to gain access to subcarinal lymph nodes. One hundred and forty one patients were included in the study (74 females, 57 males). No artificial widening of the mediastinum using saline injection was required. The study was performed in the presence of a cytopathologist; sensitivity and specificity rates were calculated. Complications were documented for each case especially for pneumothorax and haemorrhage. Results: Cytopathological diagnosis was reached in all cases. All re-aspirations were done in the same session to reach a primary diagnosis at the time of the biopsy. Imunophenotyping study was done in 94 cases to confirm the primary diagnosis and to classify the malignant lesions. No pneumothorax was encountered. Small haematomas were noted in 5 cases (3.5%). Cytopathology showed a sensitivity of 97.2% and specificity of 100%. By adding immunophenotyping a 100% sensitivity and specificity was achieved. Conclusion: Fine needle aspiration cytology (FNAC) using a 25 gauge needle for subcarinal lymph nodes via a percutaneous extrapleural paravertebral CT guided approach is a safe, minimally invasive, and tolerable procedure yielding a high sensitivity and specificity rates without the need of artificial widening.

  16. Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Yi-Ping, E-mail: yipingzhuang2010@sina.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Wang, Hai-Yan, E-mail: mycherishgirl@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Jin, E-mail: yari_zj@hotmail.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Feng, Yong, E-mail: fengyong119@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Lei, E-mail: motozl163@163.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China)

    2013-01-15

    Objective: CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions. Materials and methods: 102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness. Results: The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05). Conclusion: CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.

  17. CT-guided biopsy with cutting-edge needle for the diagnosis of malignant lymphoma: Experience of 267 biopsies

    International Nuclear Information System (INIS)

    Agid, R.; Sklair-Levy, M.; Bloom, A.I.; Lieberman, S.; Polliack, A.; Ben-Yehuda, D.; Sherman, Y.; Libson, E.

    2003-01-01

    AIM: We performed a retrospective study of 267 core needle aspiration biopsies in order to estimate the accuracy of CT-guided aspiration core needle biopsies for the diagnosis and subsequent treatment of malignant lymphoma. MATERIALS AND METHODS: Between 1989 and 1999, 267 CT-guided core needle biopsies were performed in 241 patients with either primary or recurrent malignant lymphoma. Patients age ranged from 4--88 years. One hundred and sixty-six (62.2%) nodal and 101 (37.8%) extranodal aspiration biopsies were performed using either 18 G or 20 G Turner needles. Statistical method used was Chi-square analysis. RESULTS: An accurate histological diagnosis was made in 199 (82.5%) patients, the remaining 42 (17.4%) patients had non-diagnostic CT biopsies. Thirty-seven of them were diagnosed by a surgical biopsy, four by bone marrow biopsy and in one patient by paracentesis. One hundred and seventy-nine patients had non-Hodgkin's lymphoma (NHL) and 62 had Hodgkin's disease (HD); 23 (9.54%) patients underwent repeated CT biopsy which was diagnostic in 17 (73.9%) and non-diagnostic in six (26%). CONCLUSION: CT-guided aspiration core biopsies were sufficient to establish a diagnosis in lymphoproliferative disorders in 82.5% of cases. In the light of this experience we suggest that imaging-guided core needle biopsy be used as the first step in the work up of many patients with lymphoma Agid,R. et al. (2003). Clinical Radiology58, 143-147

  18. Usefulness of CT-guided automatic needle biopsy of solitary pulmonary nodule smaller than 15 mm

    International Nuclear Information System (INIS)

    Jin, Gong Yong; Lim, Yeong Su

    2004-01-01

    To evaluate the usefulness of the CT-guided percutaneous lung biopsy for the solitary pulmonary nodules smaller than 15 mm in diameter. Between April 2002 and May 2003, we evaluated twenty-five patients (11 men, 14 women, mean ages: 52.5 years) who had solitary pulmonary nodules, which we could not discriminate as being benign or malignant on the CT findings. All the subjects had CT-guided percutaenous cutting needle biopsy (PCNB) performed on them at our institution. A definitive diagnosis of benignity or malignancy was established to retrospectively analyze the patient's records. We evaluated the accuracy, sensitivity, specificity and complications of PCNB for the definitive diagnosis of benignity or malignancy. The sensitivity and specificity of PCNB were determined using the Chi-square test, and the correlations with pneumothorax and emphysema after biopsy were analyzed using Spearman's rank correlation coefficient. In two nodules of the twenty-five nodules, no definitive diagnosis could be established. Of the remaining twenty-three nodules, 7 (30.4%) were malignant and 16 (69.6%) were benign. Twenty (87%) of the twenty-three definitively diagnosed nodules were correctly diagnosed with PCNB. Of the twenty nodules, 6 (30%) were malignant and 14 (70%) were benign. The sensitivity and specificity of the malignant nodules were 85.7% (6/7) and 100% (16/16), respectively. The sensitivity and specificity of the benign nodules were 87.5% (14/16) and 85.7% (6/7), respectively. Post-biopsy complication occurred in nine patients (36%): Hemoptysis (n=4, 16%) and pneumothorax (n=5, 20%). However, there was not a statistical significance between pneumothorax and emphysema after biopsy (r=0.3, p=0.15). When CT-guided percutaneous lung biopsy of the solitary pulmonary nodules smaller than 15 mm in diameter was performed without an on-site cytopathologist, we know that PCNB can yield high diagnostic accuracy and very few complications

  19. CT-guided core needle biopsy of pleural lesions: Evaluating diagnostic yield and associated complications

    International Nuclear Information System (INIS)

    Niu, Xiang Ke; Bhetuwal, Anup; Yang, Han Feng

    2015-01-01

    The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

  20. CT-guided core needle biopsy of pleural lesions: Evaluating diagnostic yield and associated complications

    Energy Technology Data Exchange (ETDEWEB)

    Niu, Xiang Ke [Dept. of Radiology, Affiliated Hospital of Chengdu University, Chengdu (China); Bhetuwal, Anup; Yang, Han Feng [Dept. of Radiology, Sichuan Key Laboratory of Medical Imaging, Affiliated Hospital of North Sichuan Medical College, Nanchong (China)

    2015-02-15

    The purpose of this study was to retrospectively evaluate the diagnostic accuracy and complications of CT-guided core needle biopsy (CT-guided CNB) of pleural lesion and the possible effects of influencing factors. From September 2007 to June 2013, 88 consecutive patients (60 men and 28 women; mean [+/- standard deviation] age, 51.1 +/- 14.4 years; range, 19-78 years) underwent CT-guided CNB, which was performed by two experienced chest radiologists in our medical center. Out of 88 cases, 56 (63%) were diagnosed as malignant, 28 (31%) as benign and 4 (5%) as indeterminate for CNB of pleural lesions. The final diagnosis was confirmed by either histopathological diagnosis or clinical follow-up. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and complication rates were statistically evaluated. Influencing factors (patient age, sex, lesion size, pleural-puncture angle, patient position, pleural effusion, and number of pleural punctures) were assessed for their effect on accuracy of CT-guided CNB using univariate and subsequent multivariate analysis. Diagnostic accuracy, sensitivity, specificity, PPV, and NPV were 89.2%, 86.1%, 100%, 100%, and 67.8%, respectively. The influencing factors had no significant effect in altering diagnostic accuracy. As far as complications were concerned, occurrence of pneumothorax was observed in 14 (16%) out of 88 patients. Multivariate analysis revealed lesion size/pleural thickening as a significant risk factor (odds ratio [OR]: 8.744, p = 0.005) for occurrence of pneumothorax. Moreover, presence of pleural effusion was noted as a significant protective factor (OR: 0.171, p = 0.037) for pneumothorax. CT-guided CNB of pleural lesion is a safe procedure with high diagnostic yield and low risk of significant complications.

  1. CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: Comparison between coaxial and single needle technique

    International Nuclear Information System (INIS)

    Wu, Reng-Hong; Tzeng, Wen-Sheng; Lee, Wei-Jing; Chang, Shih-Chin; Chen, Chia-Huei; Fung, Jui-Lung; Wang, Yen-Jen; Mak, Chee-Wai

    2012-01-01

    Purpose: To evaluate the complication rates and diagnostic accuracy of two different CT-guided transthoracic cutting needle biopsy techniques: coaxial method and single needle method. Methods: This study involved 198 consecutive subjects with 198 intrathoracic lesions. The first 98 consecutive subjects received a single needle cutting technique and the next 100 consecutive subjects received a coaxial technique. Both groups were compared in relation the diagnostic accuracy and complication rates. Results: No significant difference was found between the two groups concerning patient characteristics, lesions and procedure variables. There was a borderline statistical difference in the incidence of pneumothorax at within 24-h post biopsy between patients in the single needle group (5%) and the coaxial group (13%) (P = 0.053). Little difference was found in the pneumothorax rate at immediately post biopsy between the two groups, which was 28% in the single needle group and 31% in the coaxial group. There was no significant difference in the hemoptysis rate between the two groups, which was 9.2% in the single needle group and 11% in the coaxial group. Both techniques yielded an overall diagnostic accuracy of 98% for malignant lesions with similar sensitivity (single needle: 96.9% vs. coaxial: 96.4%) and specificity (single needle: 100% vs. coaxial: 100%). Conclusion: There is little difference in the pneumothorax rates and bleeding complications between patients who either received a single needle or a coaxial transthoracic cutting biopsy. Both techniques produce an overall diagnostic accuracy of 98% for malignant lesions.

  2. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT.

    Science.gov (United States)

    Chami, H A; Faraj, W; Yehia, Z A; Badour, S A; Sawan, P; Rebeiz, K; Safa, R; Saade, C; Ghandour, B; Shamseddine, A; Mukherji, D; Haydar, A A

    2015-12-01

    To evaluate the association of quantitative computed tomography (CT) measures of emphysema with the occurrence of pneumothorax after CT-guided needle lung biopsy (NLB) accounting for other risk factors. One hundred and sixty-three CT-guided NLBs performed between 2008 and 2013 with available complete chest CT within 30 days were reviewed for the occurrence of post-procedure pneumothorax. Percent emphysema was determined quantitatively as the percentage of lung voxels below -950 HU on chest CT images using automated software. Multivariable regression was used to assess the association of percent emphysema volume with the occurrence of post-procedure pneumothorax. The association of percent emphysema volume with the pneumothorax size and need for chest tube placement after NLB was also explored. Percent emphysema was significantly associated with the incidence of post-NLB pneumothorax (OR=1.10 95% confidence interval: 1.01-1.15; p=0.03) adjusting for lower-lobe lesion location, needle path length, lesion size, number of passes, and pleural needle trajectory angle. Percent emphysema was not associated with the size of the pneumothorax, nor the need for chest tube placement after NLB. Percent emphysema determined quantitatively from chest CT is a significant predictor of post-NLB pneumothorax. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. CT-guided core biopsy of malignant lung lesions: how many needle passes are needed?

    International Nuclear Information System (INIS)

    Lim, Chaehun; Han, Dae Hee; Lee, Kyo Young; Kim, Young Kyoon; Ko, Jeong Min

    2013-01-01

    The study aims to determine the number of needle pass in the CT-guided core needle biopsy (CNB) in making a diagnosis of pulmonary malignancy. A total of 434 CNB records were retrospectively reviewed. The specimen obtained from each needle pass was put in a formalin container and then labelled for separate histopathological reporting. The patients were divided into five groups according to the total number of needle passes (n=1, n=2, n=3, n=4 and n≥5). In each of the groups 2–4, it was analysed how many needle passes are required before a plateau in diagnostic yield is achieved. CNB produced 283 true-positive and 23 false-negative diagnosis of malignancy. Cumulative sensitivity significantly (P<0.05) increased between the first and second as well as the second and the third (if done) needle passes, but not between the third and fourth ones. Three coaxial needle passes might be optimal in the diagnosis of lung malignancy.

  4. Results and complications of CT-guided transthoracic fine-needle aspiration biopsy of pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Cristiano Dias de; Nunes, Rodolfo Acatauassu; Saito, Eduardo Haruo; Higa, Claudio; Cardona, Zanier Jose Fernando; Santos, Denise Barbosa dos, E-mail: cristianodiaslima@gmail.co [Hospital Universitario Pedro Ernesto (HUPE/UERJ), Rio de Janeiro, RJ (Brazil). Dept. Cirurgia Toracica

    2011-03-15

    Objective: to analyze the cytological findings of CT-guided percutaneous fine-needle aspiration biopsies of the lung, to demonstrate the diagnostic feasibility of the method in the investigation of pulmonary lesions, and to determine the complications of the procedure, evaluating its safety. Methods: a retrospective analysis of 89 patients with various types of pulmonary lesions who underwent 97 procedures over a period of five years. The patients were divided into groups regarding the indication for the procedure: suspicion of primary lung cancer (stages IIIB or IV); suspicion of lung cancer (stages I, II, or IIIA) and clinical contraindications for surgery; suspicion of pulmonary metastasis from other organs; and pulmonary lesions with benign radiological aspect. All of the procedures were performed with 25-gauge needles and were guided by spiral CT. The final diagnosis was confirmed by surgical biopsy and clinical/oncological follow-up. For the analysis of complications, the total number of procedures was considered. Results: the main indication for the procedure was suspicion of advanced stage primary lung cancer. The accuracy of the method for malignant lesions was 91.5%. The lesion was confirmed as cancer in 73% of the patients. The major complication was pneumothorax (27.8%), which required chest tube drainage in 12.4% of the procedures. Conclusions: the principal indication for CT-guided fine-needle biopsy was suspicion of primary lung cancer in patients who were not surgical candidates. The procedure has high diagnostic feasibility for malignant pulmonary diseases. The most prevalent complication was pneumothorax. However, in most cases, chest tube drainage was unnecessary. No deaths were related to the procedure. (author)

  5. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT

    International Nuclear Information System (INIS)

    Chami, H.A.; Faraj, W.; Yehia, Z.A.; Badour, S.A.; Sawan, P.; Rebeiz, K.; Safa, R.; Saade, C.; Ghandour, B.; Shamseddine, A.; Mukherji, D.; Haydar, A.A.

    2015-01-01

    Aim: To evaluate the association of quantitative computed tomography (CT) measures of emphysema with the occurrence of pneumothorax after CT-guided needle lung biopsy (NLB) accounting for other risk factors. Materials and methods: One hundred and sixty-three CT-guided NLBs performed between 2008 and 2013 with available complete chest CT within 30 days were reviewed for the occurrence of post-procedure pneumothorax. Percent emphysema was determined quantitatively as the percentage of lung voxels below −950 HU on chest CT images using automated software. Multivariable regression was used to assess the association of percent emphysema volume with the occurrence of post-procedure pneumothorax. The association of percent emphysema volume with the pneumothorax size and need for chest tube placement after NLB was also explored. Results: Percent emphysema was significantly associated with the incidence of post-NLB pneumothorax (OR=1.10 95% confidence interval: 1.01–1.15; p=0.03) adjusting for lower-lobe lesion location, needle path length, lesion size, number of passes, and pleural needle trajectory angle. Percent emphysema was not associated with the size of the pneumothorax, nor the need for chest tube placement after NLB. Conclusion: Percent emphysema determined quantitatively from chest CT is a significant predictor of post-NLB pneumothorax. - Highlights: • Examine the association between quantitative emphysema measures & post NLB pneumothorax. • The risk of post-NLB pneumothorax increases with every unit increase in percent emphysema. • Percent emphysema is a significant predictor of pneumothorax post transthoracic NLB. • Quantitative analysis of chest CT offers clinicians' objective measures to assess pneumothorax risk.

  6. CT-guided percutaneous core needle biopsy for small (≤20 mm) pulmonary lesions

    International Nuclear Information System (INIS)

    Li, Y.; Du, Y.; Yang, H.F.; Yu, J.H.; Xu, X.X.

    2013-01-01

    Aim: To assess the accuracy and risk factors for complications of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for small (≤20 mm) pulmonary lesions. Materials and methods: A retrospective study was undertaken comprising 169 patients who underwent CT-guided CNB for small (≤20 mm) pulmonary lesions. To assess the accuracy of the procedure, the diagnosis at biopsy was compared with the diagnosis after definitive surgery or clinical follow-up. The risk factors for pneumothorax and bleeding were determined by multivariate analysis of variables. Results: The overall diagnostic accuracy was 93.5%. The sensitivity for malignancy and specificity for benign lesions were 90.4% and 100%, respectively. Positive and negative predictive values were 100% and 83.3%, respectively. Twenty-five patients (14.8%) had pneumothorax after CT percutaneous CNB of the lung. The significant risk factors affecting the incidence of pneumothorax were lesion–pleural distance (p = 0.008) and needle–pleural angle (p = 0.012). The highest rate of pneumothorax correlated with a lesion–pleural distance ≥21 mm (OR = 18.46; 95%CI: 2.27–149.95) and a needle–pleural angle ≥51° (OR = 8.22; 95%CI: 2.14–31.49). Bleeding occurred in 30 patients (17.8%). The only significant risk factor affecting the incidence of bleeding was lesion–pleural distance (p = 0.011). The highest bleeding rate correlated with a lesion–pleural distance ≥21 mm (OR = 7.93; 95%CI: 1.73–36.43). Conclusion: CT-guided percutaneous CNB of small (≤20 mm) pulmonary lesions provides high diagnostic accuracy with acceptable complications. A lesion–pleural distance of ≥21 mm and needle–pleural angle of ≥51° are identified as the risk factors for highest pneumothorax rate. In addition, the needle–pleural angle is a novel predictor of pneumothorax. A lesion–pleural distance of ≥21 mm is also identified as a risk factor for the highest bleeding rate.

  7. CT-guided biopsy of thoracic lesions with a novel wire-based needle guide device - initial experiences

    Energy Technology Data Exchange (ETDEWEB)

    Kroepil, Patric; Bilk, Philip; Quentin, Michael; Miese, Falk R; Lanzman, Rotem S; Scherer, Axel (Dept. of Radiology, Medical Faculty, Univ. Duesseldorf, Duesseldorf (Germany)), email: Patric.Kroepil@med.uni-duesseldorf.de

    2011-10-15

    Background Biopsies guided by computed tomography (CT) play an important role in clinical practice. A short duration, minimal radiation dose and complication rate are of particular interest. Purpose To evaluate the potential of a novel self-manufactured wire-based needle guide device for CT-guided thoracic biopsies with respect to radiation dose, intervention time and complication rate. Material and Methods Forty patients that underwent CT-guided biopsies of thoracic lesions were included in this study and assigned to two groups. Patients in group A (n = 20, mean age 69 +- 8.4 years) underwent biopsies with a novel wire-based needle guide device, while patients in group B (n = 20, mean age 68.4 +- 10.1 years) were biopsied without a needle guide device. The novel self-manufactured needle guide device consists of an iron/zinc wire modelled to a ring with a flexible arm and an eye at the end of the arm to stabilize the biopsy needle in the optimal position during intervention. Predefined parameters (radiation dose, number of acquired CT-slices, duration of intervention, complications) were compared between both groups. Results Mean radiation dose (CTDIvol 192 mGy versus 541 mGy; P = 0.001) and the number of acquired slices during intervention (n = 49 +- 33 vs. n = 126 +- 78; P = 0.001) were significantly lower in group A compared with group B. Intervention time in group A (13.1 min) was significantly lower than in group B (18.5 min, P < 0.01). A pneumothorax as peri-interventional complication was observed less frequent after device assisted biopsies (n = 4 vs. n = 8, n.s.). Conclusion The novel wire-based needle guide device is a promising tool to facilitate CT-guided thoracic biopsies reducing radiation dose, intervention time, and related complications. Further studies are mandatory to confirm these initial results

  8. CT-guided biopsy of thoracic lesions with a novel wire-based needle guide device - initial experiences

    International Nuclear Information System (INIS)

    Kroepil, Patric; Bilk, Philip; Quentin, Michael; Miese, Falk R; Lanzman, Rotem S; Scherer, Axel

    2011-01-01

    Background Biopsies guided by computed tomography (CT) play an important role in clinical practice. A short duration, minimal radiation dose and complication rate are of particular interest. Purpose To evaluate the potential of a novel self-manufactured wire-based needle guide device for CT-guided thoracic biopsies with respect to radiation dose, intervention time and complication rate. Material and Methods Forty patients that underwent CT-guided biopsies of thoracic lesions were included in this study and assigned to two groups. Patients in group A (n = 20, mean age 69 ± 8.4 years) underwent biopsies with a novel wire-based needle guide device, while patients in group B (n = 20, mean age 68.4 ± 10.1 years) were biopsied without a needle guide device. The novel self-manufactured needle guide device consists of an iron/zinc wire modelled to a ring with a flexible arm and an eye at the end of the arm to stabilize the biopsy needle in the optimal position during intervention. Predefined parameters (radiation dose, number of acquired CT-slices, duration of intervention, complications) were compared between both groups. Results Mean radiation dose (CTDIvol 192 mGy versus 541 mGy; P = 0.001) and the number of acquired slices during intervention (n = 49 ± 33 vs. n = 126 ± 78; P = 0.001) were significantly lower in group A compared with group B. Intervention time in group A (13.1 min) was significantly lower than in group B (18.5 min, P < 0.01). A pneumothorax as peri-interventional complication was observed less frequent after device assisted biopsies (n = 4 vs. n = 8, n.s.). Conclusion The novel wire-based needle guide device is a promising tool to facilitate CT-guided thoracic biopsies reducing radiation dose, intervention time, and related complications. Further studies are mandatory to confirm these initial results

  9. CT-guided biopsy of pulmonary lesions : a comparison of diagnostic accuracy and complication rate between automated gun biopsy and fine needle aspiration biopsy

    International Nuclear Information System (INIS)

    Kim, Keon Woo; Kang, Duk Sik

    1998-01-01

    The purpose of this study is to compare the efficacy and safety of CT-guided automated gun biopsy with those of fine needle aspiration biopsy of pulmonary lesions. Under CT guidance, we performed automated gu biopsies in 115 cases of 109 patients and fine needle aspiration biopsies in 119 cases of 108 patients with pulmonary lesions. Between the two methods, we compared the diagnostic rate, diagnostic accuracy and frequency of compilations according to the depth and diameter of pulmonary lesions. The overall diagnostic rates of automated gun biopsy and fine needle aspiration biopsy were 76.5 % (88/115) and 64.7 % (77/119) respectively. There was a significant statistical difference (p=0.048), especially in the case of malignant lesions less than 3 cm (p=0.027) and more than 6 cm in maximal diameter (p=0.008), and in the lesions located from 1 cm to less than 3 cm from the pleural (p=0.030), as seen on CT. There was no significant statistical difference in the frequency of complications. Automated gun biopsy of pulmonary lesions under CT guidance is safe, with complications rate comparable to those of fine needle aspiration biopsy. A higher overall diagnostic rate can be achieved by automated gun biopsy than by fine needle aspiration biopsy. For the diagnosis of pulmonary lesions under CT guidance, automated gun biopsy is therefore a more useful procedure than fine needle aspiration biopsy. (author). 24 refs., 3 tabs

  10. Development and Evaluation of a Novel Curved Biopsy Device for CT-Guided Biopsy of Lesions Unreachable Using Standard Straight Needle Trajectories

    Energy Technology Data Exchange (ETDEWEB)

    Schulze-Hagen, Maximilian Franz, E-mail: mschulze@ukaachen.de; Pfeffer, Jochen; Zimmermann, Markus; Liebl, Martin [University Hospital RWTH Aachen, Department of Diagnostic and Interventional Radiology (Germany); Stillfried, Saskia Freifrau von [University Hospital RWTH Aachen, Department of Pathology (Germany); Kuhl, Christiane; Bruners, Philipp; Isfort, Peter [University Hospital RWTH Aachen, Department of Diagnostic and Interventional Radiology (Germany)

    2017-06-15

    PurposeTo evaluate the feasibility of a novel curved CT-guided biopsy needle prototype with shape memory to access otherwise not accessible biopsy targets.Methods and MaterialsA biopsy needle curved by 90° with specific radius was designed. It was manufactured using nitinol to acquire shape memory, encased in a straight guiding trocar to be driven out for access of otherwise inaccessible targets. Fifty CT-guided punctures were conducted in a biopsy phantom and 10 CT-guided punctures in a swine corpse. Biposies from porcine liver and muscle tissue were separately gained using the biopsy device, and histological examination was performed subsequently.ResultsMean time for placement of the trocar and deployment of the inner biopsy needle was ~205 ± 69 and ~93 ± 58 s, respectively, with a mean of ~4.5 ± 1.3 steps to reach adequate biopsy position. Mean distance from the tip of the needle to the target was ~0.7 ± 0.8 mm. CT-guided punctures in the swine corpse took relatively longer and required more biopsy steps (~574 ± 107 and ~380 ± 148 s, 8 ± 2.6 steps). Histology demonstrated appropriate tissue samples in nine out of ten cases (90%).ConclusionsTargets that were otherwise inaccessible via standard straight needle trajectories could be successfully reached with the curved biopsy needle prototype. Shape memory and preformed size with specific radius of the curved needle simplify the target accessibility with a low risk of injuring adjacent structures.

  11. Predicting factors for conversion from fluoroscopy guided Percutaneous transthoracic needle biopsy to cone-beam CT guided Percutaneous transthoracic needle biopsy

    International Nuclear Information System (INIS)

    Lee, Kang Ji; Han, Young Min; Jin, Gong Yong; Song, Ji Soo

    2015-01-01

    To evaluate the predicting factors for conversion from fluoroscopy guided percutaneous transthoracic needle biopsy (PTNB) to cone-beam CT guided PTNB. From January 2011 to December 2012, we retrospectively identified 38 patients who underwent cone-beam CT guided PTNB with solid pulmonary lesions, and 76 patients who underwent fluoroscopy guided PTNB were matched to the patients who underwent cone-beam CT guided PTNB for age, sex, and lesion location. We evaluated predicting factors such as, long-axis diameter, short-axis diameter, anterior-posterior diameter, and CT attenuation value of the solid pulmonary lesion affecting conversion from fluoroscopy guided PTNB to cone-beam CT guided PTNB. Pearson χ 2 test, Fisher exact test, and independent t test were used in statistical analyses; in addition, we also used receiver operating characteristics curve to find the proper cut-off values affecting the conversion to cone-beam CT guided PTNB. Short-axis, long-axis, anterior-posterior diameter and CT attenuation value of the solid pulmonary lesion in patients who underwent fluoroscopy guided PTNB were 2.70 ± 1.57 cm, 3.40 ± 1.92 cm, 3.06 ± 1.81 cm, and 35.67 ± 15.70 Hounsfield unit (HU), respectively. Short-axis, long-axis, anterior-posterior diameter and CT attenuation value of the solid pulmonary lesion in patients who underwent cone-beam CT guided PTNB were 1.60 ± 1.30 cm, 2.20 ± 1.45 cm, 1.91 ± 1.99 cm, and 18.32 ± 23.11 HU, respectively. Short-axis, long-axis, anterior-posterior diameter, and CT attenuation value showed a significantly different mean value between the 2 groups (p = 0.001, p < 0.001, p = 0.003, p < 0.001, respectively). Odd ratios of CT attenuation value and short-axis diameter of the solid pulmonary lesion were 0.952 and 0.618, respectively. Proper cut-off values affecting the conversion to cone-beam CT guided PTNB were 1.65 cm (sensitivity 68.4%, specificity 71.1%) in short-axis diameter and 29.50 HU (sensitivity 65.8%, specificity 65.8%) in

  12. Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

    International Nuclear Information System (INIS)

    Pianta, Marcus; Chock, Eric; Schlicht, Stephen; McCombe, David

    2015-01-01

    This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics. 41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed. 41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain. Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy. (orig.)

  13. Accuracy and complications of CT-guided core needle biopsy of peripheral nerve sheath tumours

    Energy Technology Data Exchange (ETDEWEB)

    Pianta, Marcus; Chock, Eric; Schlicht, Stephen [St Vincent' s Hospital, Fitzroy, VIC (Australia); McCombe, David [St Vincent' s Hospital and Victorian Hand Surgery Associates, Victoria (Australia)

    2015-09-15

    This single-centre study retrospectively reviews the complications in patients that have occurred following peripheral nerve sheath tumour biopsy, and assesses whether there is an association with biopsy technique or underlying lesion characteristics. 41 consecutive core needle biopsies of proven peripheral nerve sheath tumours over a 2-year period in a tertiary teaching hospital were reviewed. Patient demographics and symptoms, tumour characteristics and radiological appearances were recorded. Biopsy and surgical histology were correlated, and post-biopsy and surgical complications analyzed. 41 biopsies were performed in 38 patients. 68 % schwannomas, 24 % neurofibromas and 7 % malignant peripheral nerve sheath tumours. Biopsy histology correlated with surgery in all cases. 71 % of lesions were surgically excised. 60 % of patients reported pain related to their lesion. Following the biopsy, 12 % reported increased pain, which resolved in all cases. Pain exacerbation was noted in tumours smaller in size, more superficial and in closer proximity of the biopsy needle tip to the traversing nerve. Number of biopsy needle passes was not associated with an increased incidence of procedure-related pain. Core biopsy of a suspected peripheral nerve sheath tumour may be performed safely before excisional surgery to confirm lesion histology and assist prognosis. There is excellent correlation between core biopsy and excised surgical specimen histology. The most common complication of pain exacerbation is seen in a minority and is temporary, and more likely with smaller, more superficial lesions and a closer needle-tip to traversing nerve distance during biopsy. (orig.)

  14. Biopsy system for CT-guided biopsies

    International Nuclear Information System (INIS)

    Onik, G.; Cosman, E.; Wells, T.; Goldberg, H.I.; Moss, A.; Costello, P.; Kane, R.

    1987-01-01

    CT stereotaxic brain biopsies have made brain biopsies safe and minimally invasive. CT-guided biopsies of the body, however, have traditionally used a hand-guidance method. CT biopsy guidance systems for the body have recently become available that have similar capabilities as those of brain biopsy systems. To compare the clinical utility of stereotaxically guided biopsies with hand-guided biopsies, the authors prospectively compared 40 biopsies performed with each method. In the stereotaxic method, a localizor grid was placed on the patient to define a reference point, and a frame was used to guide the needle along the intended path. Computer software programs calculated complex paths from one scan plane to another. Although the results disclosed no significant differences in lesion size or path length between the two groups, the stereotaxically guided biopsies required 75% fewer needle manipulations to hit the intended target. Consequently, the stereotaxically guided biopsies required 40% less time and 80% fewer localization scans to find the biopsy needle than did the hand-guided biopsies

  15. CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases

    International Nuclear Information System (INIS)

    Puri, A.; Shingade, V.U.; Agarwal, M.G.; Anchan, C.; Juvekar, S.; Desai, S.; Jambhekar, N.A.

    2006-01-01

    Although large lesions of the limbs can easily be biopsied without image guidance, lesions in the spine, paraspinal area and pelvis are difficult to target, and benefit from CT guidance to improve the accuracy of targeting the lesion for biopsy purposes. A prospective study of CT-guided core needle biopsies for deep-seated musculoskeletal lesions was conducted at a referral cancer institute over a 4-year period with the aim of assessing the safety and efficacy of the procedure. From January 2000 to December 2003, 136 consecutive CT-guided biopsy sessions were undertaken for musculoskeletal lesions in 128 patients comprising 73 males and 55 females. The following data was recorded in all patients: demographic data, suspected clinicoradiological diagnosis, data related to core biopsy session (date, site, approach, total time required in minutes, number of cores, surgeon satisfaction with adequacy of cores), patient discomfort, complications, histopathology report and number of further sessions if material obtained during the first biopsy session was not confirmatory. The sample obtained during the biopsy session was considered inconclusive if, in the opinion of the pathologist, inadequate or non-representative tissue had been obtained. The diagnosis was considered inaccurate if the final histopathological diagnosis did not match with the biopsy diagnosis, or if subsequent clinicoradiological evaluation at follow up did not correlate with the biopsy diagnosis in those patients who were treated with modalities other than surgery. In 121 patients, a single session was sufficient to obtain representative material, whilst for six patients two sessions, and for one patient three sessions were necessary. The time taken for biopsy, including the pre-biopsy CT examination time, varied from 15 min to 60 min (median 30 min). For 110 bony lesions 116 sessions were required, and for 18 soft-tissue lesions 20 sessions were required. 108 biopsy sessions yielded a diagnosis, whilst

  16. Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Min, Lingfeng; Xu, Xingxiang [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China); Song, Yong [Jinling Hospital, Nanjing University School of Medical, Nanjing 210002, Jiangsu (China); Issahar, Ben-Dov [Pulmonary Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Israel); Wu, Jingtao; Zhang, Le; Huang, Qian [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China); Chen, Mingxiang, E-mail: chenmx1129@126.com [Subei People' s Hospital of Jiangsu Province, Clinical Medical School of Yangzhou University, Yangzhou 225001, Jiangsu (China)

    2013-01-15

    Purpose: To assess the effect of a breath-hold after forced expiration on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions. Materials and methods: Between January 2008 and December 2011, percutaneous CT-guided lung biopsy was performed in 440 patients. Two hundred and twenty-one biopsies were performed without (control group) and two hundred and nineteen biopsies were performed with (study group) the study maneuver – a breath-hold after forced expiratory approach. Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographics, lesion characteristics, and biopsy technique. Results: A reduced number of pneumothoraces (18 [8.2%] vs 35 [15.8%]; P = 0.014) but no significant difference in rate of drainage catheter insertions (2 [0.9%] vs (4 [1.8%]; P = 0.418) were noted in the study group as compared with the control group. By logistic regression analysis, three factors significantly and independently affected the risk for pneumothorax including lesion size (transverse and longitudinal diameter), distance from pleura and utilizing or avoiding the breath-hold after deep expiration maneuver. Conclusion: Breath-holding after forced expiration before removal of the biopsy needle during the percutaneous CT-guided transthoracic lung biopsy almost halved the rate of overall pneumothorax. Small lesion size (longitudinal diameter) and the distance from pleura were also predictors of pneumothorax in our study.

  17. Breath-hold after forced expiration before removal of the biopsy needle decreased the rate of pneumothorax in CT-guided transthoracic lung biopsy

    International Nuclear Information System (INIS)

    Min, Lingfeng; Xu, Xingxiang; Song, Yong; Issahar, Ben-Dov; Wu, Jingtao; Zhang, Le; Huang, Qian; Chen, Mingxiang

    2013-01-01

    Purpose: To assess the effect of a breath-hold after forced expiration on the rate of pneumothorax after computed tomography (CT)-guided transthoracic needle biopsy of pulmonary lesions. Materials and methods: Between January 2008 and December 2011, percutaneous CT-guided lung biopsy was performed in 440 patients. Two hundred and twenty-one biopsies were performed without (control group) and two hundred and nineteen biopsies were performed with (study group) the study maneuver – a breath-hold after forced expiratory approach. Multivariate analysis was performed between groups for risk factors for pneumothorax, including patient demographics, lesion characteristics, and biopsy technique. Results: A reduced number of pneumothoraces (18 [8.2%] vs 35 [15.8%]; P = 0.014) but no significant difference in rate of drainage catheter insertions (2 [0.9%] vs (4 [1.8%]; P = 0.418) were noted in the study group as compared with the control group. By logistic regression analysis, three factors significantly and independently affected the risk for pneumothorax including lesion size (transverse and longitudinal diameter), distance from pleura and utilizing or avoiding the breath-hold after deep expiration maneuver. Conclusion: Breath-holding after forced expiration before removal of the biopsy needle during the percutaneous CT-guided transthoracic lung biopsy almost halved the rate of overall pneumothorax. Small lesion size (longitudinal diameter) and the distance from pleura were also predictors of pneumothorax in our study

  18. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method.

    Science.gov (United States)

    Kakizawa, Hideaki; Toyota, Naoyuki; Hieda, Masashi; Hirai, Nobuhiko; Tachikake, Toshihiro; Matsuura, Noriaki; Oda, Miyo; Ito, Katsuhide

    2010-09-01

    The purpose of this study is to evaluate the risk factors for the severity of pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy using the single-needle method. We reviewed 91 biopsy procedures for 90 intrapulmonary lesions in 89 patients. Patient factors were age, sex, history of ipsilateral lung surgery and grade of emphysema. Lesion factors were size, location and pleural contact. Procedure factors were position, needle type, needle size, number of pleural punctures, pleural angle, length of needle passes in the aerated lung and number of harvesting samples. The severity of pneumothorax after biopsy was classified into 4 groups: "none", "mild", "moderate" and "severe". The risk factors for the severity of pneumothorax were determined by multivariate analyzing of the factors derived from univariate analysis. Pneumothorax occurred in 39 (43%) of the 91 procedures. Mild, moderate, and severe pneumothorax occurred in 24 (26%), 8 (9%) and 7 (8%) of all procedures, respectively. Multivariate analysis showed that location, pleural contact, number of pleural punctures and number of harvesting samples were significantly associated with the severity of pneumothorax (p < 0.05). In conclusion, lower locations and non-pleural contact lesions, increased number of pleural punctures and increased number of harvesting samples presented a higher severity of pneumothorax.

  19. Risk factors for severity of pneumothorax after CT-guided percutaneous lung biopsy using the single-needle method

    International Nuclear Information System (INIS)

    Kakizawa, Hideaki; Hieda, Masashi; Oda, Miyo; Toyota, Naoyuki; Hirai, Nobuhiko; Tachikake, Toshihiro; Matsuura, Noriaki; Ito, Katsuhide

    2010-01-01

    The purpose of this study is to evaluate the risk factors for the severity of pneumothorax after computed tomography (CT)-guided percutaneous lung biopsy using the single-needle method. We reviewed 91 biopsy procedures for 90 intrapulmonary lesions in 89 patients. Patient factors were age, sex, history of ipsilateral lung surgery and grade of emphysema. Lesion factors were size, location and pleural contact. Procedure factors were position, needle type, needle size, number of pleural punctures, pleural angle, length of needle passes in the aerated lung and number of harvesting samples. The severity of pneumothorax after biopsy was classified into 4 groups: 'none', 'mild', 'moderate' and 'severe'. The risk factors for the severity of pneumothorax were determined by multivariate analyzing of the factors derived from univariate analysis. Pneumothorax occurred in 39 (43%) of the 91 procedures. Mild, moderate, and severe pneumothorax occurred in 24 (26%), 8 (9%) and 7 (8%) of all procedures, respectively. Multivariate analysis showed that location, pleural contact, number of pleural punctures and number of harvesting samples were significantly associated with the severity of pneumothorax (p<0.05). In conclusion, lower locations and non-pleural contact lesions, increased number of pleural punctures and increased number of harvesting samples presented a higher severity of pneumothorax. (author)

  20. Percutaneous CT-guided needle biopsies of musculoskeletal tumors: a 5-year analysis of non-diagnostic biopsies

    International Nuclear Information System (INIS)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Torriani, Martin; Rosenthal, Daniel I.; Halpern, Elkan F.; Springfield, Dempsey S.

    2015-01-01

    To study non-diagnostic CT-guided musculoskeletal biopsies and take steps to minimize them. Specifically we asked: (1) What malignant diagnoses have a higher non-diagnostic rate? (2) What factors of a non-diagnostic biopsy may warrant more aggressive pursuit? (3) Do intra-procedural frozen pathology (FP) or point-of-care (POC) cytology reduce the non-diagnostic biopsy rate ?This study was IRB-approved and HIPAA-compliant. We retrospectively reviewed 963 consecutive CT-guided musculoskeletal biopsies. We categorized pathology results as malignant, benign, or non-diagnostic and recorded use of FP or POC cytology. Initial biopsy indication, final diagnosis, method of obtaining the final diagnosis of non-diagnostic biopsies, age of the patient, and years of biopsy attending experience were recorded. Groups were compared using Pearson's χ 2 test or Fisher's exact test. In all, 140 of 963 (15 %) biopsies were non-diagnostic. Lymphoma resulted in more non-diagnostic biopsies (P < 0.0001). While 67% of non-diagnostic biopsies yielded benign diagnoses, 33% yielded malignant diagnoses. Patients whose percutaneous biopsy was indicated due to the clinical context without malignancy history almost always generated benign results (96 %). Whereas 56% of biopsies whose indication was an imaging finding of a treatable lesion were malignant, 20% of biopsies whose indication was a history of malignancy were malignant. There was no statistically significant difference in the nondiagnostic biopsy rates of pediatric versus adult patients (P = 0.8) and of biopsy attendings with fewer versus more years of experience (P = 0.5). The non-diagnostic rates of biopsies with FP (8 %), POC cytology (25 %), or neither (24 %) were significantly different (P < 0.0001). Lymphoma is the malignant diagnosis most likely to result in a non-diagnostic biopsy. If the clinical and radiologic suspicion for malignancy is high, repeat biopsy is warranted. If the clinical context suggests a benign

  1. Percutaneous CT-guided needle biopsies of musculoskeletal tumors: a 5-year analysis of non-diagnostic biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Huang, Ambrose J.; Bredella, Miriam A.; Torriani, Martin; Rosenthal, Daniel I. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute for Technology Assessment, Department of Radiology, Boston, MA (United States); Springfield, Dempsey S. [Massachusetts General Hospital, Department of Orthopedics, Boston, MA (United States)

    2015-12-15

    To study non-diagnostic CT-guided musculoskeletal biopsies and take steps to minimize them. Specifically we asked: (1) What malignant diagnoses have a higher non-diagnostic rate? (2) What factors of a non-diagnostic biopsy may warrant more aggressive pursuit? (3) Do intra-procedural frozen pathology (FP) or point-of-care (POC) cytology reduce the non-diagnostic biopsy rate ?This study was IRB-approved and HIPAA-compliant. We retrospectively reviewed 963 consecutive CT-guided musculoskeletal biopsies. We categorized pathology results as malignant, benign, or non-diagnostic and recorded use of FP or POC cytology. Initial biopsy indication, final diagnosis, method of obtaining the final diagnosis of non-diagnostic biopsies, age of the patient, and years of biopsy attending experience were recorded. Groups were compared using Pearson's χ{sup 2} test or Fisher's exact test. In all, 140 of 963 (15 %) biopsies were non-diagnostic. Lymphoma resulted in more non-diagnostic biopsies (P < 0.0001). While 67% of non-diagnostic biopsies yielded benign diagnoses, 33% yielded malignant diagnoses. Patients whose percutaneous biopsy was indicated due to the clinical context without malignancy history almost always generated benign results (96 %). Whereas 56% of biopsies whose indication was an imaging finding of a treatable lesion were malignant, 20% of biopsies whose indication was a history of malignancy were malignant. There was no statistically significant difference in the nondiagnostic biopsy rates of pediatric versus adult patients (P = 0.8) and of biopsy attendings with fewer versus more years of experience (P = 0.5). The non-diagnostic rates of biopsies with FP (8 %), POC cytology (25 %), or neither (24 %) were significantly different (P < 0.0001). Lymphoma is the malignant diagnosis most likely to result in a non-diagnostic biopsy. If the clinical and radiologic suspicion for malignancy is high, repeat biopsy is warranted. If the clinical context suggests a

  2. CT-guided transthoracic core needle biopsy for small pulmonary lesions: diagnostic performance and adequacy for molecular testing.

    Science.gov (United States)

    Tian, Panwen; Wang, Ye; Li, Lei; Zhou, Yongzhao; Luo, Wenxin; Li, Weimin

    2017-02-01

    Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions. This study included CT-guided TCNB with 18-gauge cutting needles in 560 consecutive patients with small (≤3 cm) pulmonary lesions from January 2012 to January 2015. There were 323 males and 237 females, aged 51.8±12.7 years. The size of the pulmonary lesions was 1.8±0.6 cm. The sensitivity, specificity, accuracy and complications of the biopsies were investigated. The risk factors of diagnostic failure were assessed using univariate and multivariate analyses. The sample's adequacy for molecular testing of non-small cell lung cancer (NSCLC) was analyzed. The overall sensitivity, specificity, and accuracy for diagnosis of malignancy were 92.0% (311/338), 98.6% (219/222), and 94.6% (530/560), respectively. The incidence of bleeding complications was 22.9% (128/560), and the incidence of pneumothorax was 10.4% (58/560). Logistic multivariate regression analysis showed that the independent risk factors for diagnostic failure were a lesion size ≤1 cm [odds ratio (OR), 3.95; P=0.007], lower lobe lesions (OR, 2.83; P=0.001), and pneumothorax (OR, 1.98; P=0.004). Genetic analysis was successfully performed on 95.45% (168/176) of specimens diagnosed as NSCLC. At least 96.8% of samples with two or more passes from a lesion were sufficient for molecular testing. The diagnostic yield of small pulmonary lesions by CT-guided TCNB is high, and the procedure is relatively safe. A lesion size ≤1 cm, lower lobe lesions, and pneumothorax are independent risk factors for biopsy diagnostic failure. TCNB specimens could provide adequate tissues for molecular testing.

  3. Percutaneous CT-Guided Core Needle Biopsy Versus Fine Needle Aspiration in Diagnosing Pneumonia and Mimics of Pneumonia

    International Nuclear Information System (INIS)

    Thanos, Loukas; Galani, Panagiota; Mylona, Sophia; Pomoni, Maria; Mpatakis, Nikolaos

    2004-01-01

    The purpose of this study was to determine the diagnostic value of percutaneous core needle biopsy (CNB) relative to fine needle aspiration (FNA) in patients with pneumonia and pneumonia mimics. In this prospective study we present our experience with 48 thoracic FNAs and CNBs carried out on 48 patients with pneumonia and pneumonia mimics. Samples were obtained from all patients using both CNB (with an automated 18-G core biopsy needle and a gun) and FNA (with a 22-G needle). A specific diagnosis was made in 10/48 cases (20.83%) by FNA and in 42/48 (87.5%) by CNB. The main complications encountered were pneumothorax (n = 4) and hemoptysis (n = 2), yielding a total complication rate of 12.5%. We concluded that CNB using an automated biopsy gun results in a higher diagnostic accuracy for pneumonia and pneumonia mimic biopsies than FNA. Complications should be considered and proper patient observation should follow the procedure

  4. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years.

    Science.gov (United States)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong

    2017-08-01

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. • CT-guided core needle biopsy is an accurate technique for diagnosing mediastinal nodes. • The rates of complications are similar to those for pulmonary lesion biopsy. • Pneumothorax risk factors include distance from pleura to target lesion and number of visceral pleura. • Distance from pleura to target lesion is the risk factor for hemoptysis. • CT-guided core needle biopsy is an important diagnostic method for mediastinal nodes.

  5. Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Yi-Ping; Wang, Hai-Yan; Zhang, Jin; Feng, Yong (Dept. of Radiology, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China)), email: yipingzhuang2010@sina.com; Shi, Mei-Qi (Dept. of Chemotherapy, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China))

    2011-12-15

    Background. The safety of using a cutting needle when performing a core-needle biopsy is of major concern, in particular for small lung tumors or tumors near the hilum. Purpose. To investigate the usefulness of CT-guided fine needle aspiration biopsy (FNAB) of the lung in obtaining tumor tissue for epidermal growth factor receptor (EGFR) mutation analysis in advanced lung cancer patients. Material and Methods. Forty-three patients with stage IIIB-IV lung cancer were enrolled. In all patients, CT-guided FNAB was performed using an 18-gauge or 20-gauge Chiba aspiration needle for histology diagnosis and EGFR mutation analysis. Complications associated with CT-guided FNAB were observed, and the specimen mutational assessments were recorded. Results. The obtained tumor samples ranged from 0.5-1.5 cm in length and were adequate for histological and DNA analyses in all patients. No patient had a pneumothorax or hemoptysis. Minor needle tract bleeding appeared in eight patients. Mutation analysis was satisfactorily demonstrated in 23 mutations and 20 non-mutations. Ten and 13 mutations were identified by 18-gauge and 20-gauge needle biopsies, respectively. EFGR mutations, including 12 cases of EGFR exon 19 deletion and 11 cases of exon 21 point mutation, were present in 21 patients with adenocarcinomas, one with squamous cell carcinoma, and one with undifferentiated carcinoma. Conclusion. CT-guided FNAB is a feasible and safe technique for obtaining lung tumor tissues for EGFR gene mutation analysis

  6. Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

    Science.gov (United States)

    Noh, Tae June; Lee, Chang Hoon; Kang, Young Ae; Kwon, Sung-Youn; Yoon, Ho-Il; Kim, Tae Jung; Lee, Kyung Won; Lee, Jae Ho

    2009-01-01

    Background/Aims This study examined the correlation between pneumothorax detected by immediate post-transthoracic needle aspiration-biopsy (TTNB) chest computed tomography (CT) and overt pneumothorax detected by chest PA, and investigated factors that might influence the correlation. Methods Adult patients who had undergone CT-guided TTNB for lung lesions from May 2003 to June 2007 at Seoul National University Bundang Hospital were included. Immediate post-TTNB CT and chest PA follow-up at 4 and 16 hours after CT-guided TTNB were performed in 934 patients. Results Pneumothorax detected by immediate chest CT (CT-pneumothorax) was found in 237 (25%) and overt pneumothorax was detected by chest PA follow-up in 92 (38.8%) of the 237 patients. However, overt pneumothorax was found in 18 (2.6%) of the 697 patients without CT-pneumothorax. The width and depth of CT-pneumothorax were predictive risk factors for overt pneumothorax. Conclusions CT-pneumothorax is very sensitive for predicting overt pneumothorax, and the width and depth on CT-pneumothorax are reliable risk factors for predicting overt pneumothorax. PMID:19949733

  7. Complications after CT guided trans thoracic needle biopsy: a 1000 patients-series of pulmonary lesions

    International Nuclear Information System (INIS)

    Velan, Osvaldo; Ayzaguer, Alejandro

    2000-01-01

    To evaluate the complications of the percutaneous biopsy (PB) of pulmonary lesions, the predisposing factors and the behavior to be followed, we compared our experience with the one from other authors. We reviewed 1000 pulmonary biopsies (687 males), finding 78 pneumothorax (4 drained with tube and hospital admittance; 11 drained at the moment of the examination; the rest controlled), 65 pulmonary hemorrhages (1 died). Other complications were: a) hemoptysis (n=9); b) pain (n=4); c) hemo pleura (n=3); d) hypotension (n=1); e) cough (n=1). The PB is a top alternative to establish the etiology of the pulmonary lesion. As with any surgery, there is always the potential risk of complications. In our case, the most frequent ones were the pneumothorax and the intrapulmonary hemorrhage, with or without hemoptysis. With most of the pneumothorax an expectant management was observed, or else they were drained by the physician. When comparing the experience of other authors about the pneumothorax, we underline the following differences: a) Higher incidence in biopsies with posterior access in the middle third of the lung; b) Less total incidence (7,8%); c) Higher incidence of pneumothorax in masses with pleural contact without healthy lung in the needle path (30%); d) The size of the lesion up to 4 cm in diameter was not a significant predisposing factor; e) The conservative management in most of the cases. Although rare, other complications existed, including the death of one patient. (author)

  8. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong [Huazhong University of Science and Technology, Cancer Center, Union Hospital, Tongji Medical College, Wuhan (China)

    2017-08-15

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. (orig.)

  9. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Luciana Vargas; Souza Júnior, Arthur Soares, E-mail: fabianonatividade@terra.com.br [Rio Preto-Ultra-X Radiological Diagnosis Institute, São José do Rio Preto, SP (Brazil)

    2014-07-15

    Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively). Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy. (author)

  10. CT Guided biopsies of musculoskeletal lesions, radiological and pathologic correlation

    International Nuclear Information System (INIS)

    Hadzihasanovic, B.; Milisic, L.; Zuban, J.; Mujic, E.; Jahic, E.; Gjikolli, B.; Hasanovic, B.; Lincender-Cvijetic, L.; Jaganjac, S.

    2006-01-01

    Full text: The aim of the study is to overview our experiences in taking the CT guided biopsies of musculoskeletal lesions during the period of sixteen months, analysis of validity of samples taken and correlation with pathological findings. CT guided biopsies of musculoskeletal lesions were performed in 32 patients during the period of sixteen months (from December 2004 until March 2006). Age range was from 13 to 78 years. Majorities of the biopsies were performed with coaxial cutting needle system (14 G and 16 G) with introducers size 13 and 15 G. Bone biopsies were performed with Yamsidi needles in purpose of taking the bone cylinder. Majorities of the biopsies were performed under local anaesthesia except a thirteen years old child to whom CT guided biopsy of corpus Th 6 was performed under general anaesthesia. Two samples of tissues were sent in formalin solutions to Pathology Institute for pathological verification. In one case of musculoskeletal lesions CT guided biopsies didn't yield a representative tissue sample. We had high level of congruence between radiological and pathological findings; precise presented in the article. CT guided biopsies of musculoskeletal lesions are method of choice for pathologic verification of musculoskeletal lesions proving incomparable less risk compared to 'open' biopsy which requires operating theatre and general anaesthesia. Coaxial needle systems has shown as suitable for yielding representative tissue samples (two samples for each patient), and samples are also appropriate for immunohistochemical analysis

  11. Combined Fluoroscopy- and CT-Guided Transthoracic Needle Biopsy Using a C-Arm Cone-Beam CT System: Comparison with Fluoroscopy-Guided Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, Joo Yeon; Kim, Yoo Kyung; Shim, Sung Shine; Lim, Soo Mee [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2011-02-15

    The aim of this study was to evaluate the usefulness of combined fluoroscopy- and CT-guided transthoracic needle biopsy (FC-TNB) using a cone beam CT system in comparison to fluoroscopy-guided TNB (F-TNB). We retrospectively evaluated 74 FC-TNB cases (group A) and 97 F-TNB cases (group B) to compare their respective diagnostic accuracies according to the size and depth of the lesion, as well as complications, procedure time, and radiation dose. The sensitivity for malignancy and diagnostic accuracy for small (< 30 mm in size) and deep ({>=} 50 mm in depth) lesions were higher in group A (91% and 94%, 92% and 94%) than in group B (73% and 81%, 84% and 88%), however not statistically significant (p > 0.05). Concerning lesions {>=} 30 mm in size and < 50 mm in depth, both groups displayed similar results (group A, 91% and 92%, 80% and 87%: group B, 90% and 92%, 86% and 90%). Pneumothorax occurred 26% of the time in group A and 14% for group B. The mean procedure time and patient skin dose were significantly higher in group A (13.6 {+-} 4.0 minutes, 157.1 {+-} 76.5 mGy) than in group B (9.0 {+-} 3.5 minutes, 21.9 {+-} 15.2 mGy) (p < 0.05). Combined fluoroscopy- and CT-guided TNB allows the biopsy of small (< 30 mm) and deep lesions ({>=} 50 mm) with high diagnostic accuracy and short procedure times, whereas F-TNB is still a useful method for large and superficial lesions with a low radiation dose

  12. Isolate pulmonary nodule. CT-guided biopsy

    International Nuclear Information System (INIS)

    Bruneton, J.N.; Ettore, F.; Rogopoulos, A.; Geoffray, A.; Balu-Maestro, C.; Le Houcq, M.

    1989-01-01

    Transparietal CT-guided biopsy location can be successfully performed for isolate pulmonary nodules, defined as lesions with a maximal diameter of 3 cm, without any other parenchymal or mediastinal abnormality. A 21 G needle has been used according to an identical protocole in 64 cases (10 benign, 54 malignant). The biopsy was successful in 77.7% of the malignant cases. In relation to the diameter of the nodules, biopsy was successful in 66.7% of the nodules smaller than 2 cm and in 76% of the nodules ranging from 2 to 3 cm. The complications observed were rare (1 case of pneumothorax requiring drainage, 9 cases of pneumothorax without clinical signs and simply followed up, 4 cases of minor hemoptysis requiring no treatment and 5 cases of hematomas smaller than 5 cm on CT) [fr

  13. Retrospective analysis of technical success rate and procedure-related complications of 867 percutaneous CT-guided needle biopsies of lung lesions.

    Science.gov (United States)

    Mills, M; Choi, J; El-Haddad, G; Sweeney, J; Biebel, B; Robinson, L; Antonia, S; Kumar, A; Kis, B

    2017-12-01

    To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (ptechnical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  14. CT-guided needle biopsy in the diagnosis of lung adenocarcinoma accompanied by extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: a rare combination.

    Science.gov (United States)

    Tian, Panwen; Wang, Ye; Wan, Chun; Shen, Yongchun; Wen, Fuqiang

    2015-01-01

    We represent a rare case of lung adenocarcinoma accompanied by extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT). The patient was a 66-year-old male presented with 1 month history of recurrent cough and hemoptysis. Chest CT showed solitary ground-glass opacity (GGO) in the upper lobe of the right lung and mediastinal lymph node enlargement in station 3p. A CT-guided transthoracic needle biopsy was performed. Tissue specimens of the GGO revealed a typical adenocarcinoma. Histopathologic diagnosis of mediastinal lymph node was extranodal marginal zone lymphoma of MALT. Because of its rarity, extranodal marginal zone lymphoma of MALT should be considered in the differential diagnosis when we encounter mediastinal lymphadenopathy in patients with lung adenocarcinoma.

  15. CT-Guided Percutaneous Fine-Needle Aspiration Biopsy of the Inferior Vena Cava Wall: A Posterior Coaxial Approach

    International Nuclear Information System (INIS)

    Kos, Sebastian; Bilecen, Deniz; Baumhoer, Daniel; Guillaume, Nicolas; Jacob, Augustinus L.

    2010-01-01

    A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.

  16. CT-guided biopsies and drainage

    International Nuclear Information System (INIS)

    Scheppers, I.; Wollschlaeger, D.

    2011-01-01

    Following the implementation of computed tomography (CT) or ultrasound-guided biopsy of solid tumors and the puncture and drainage of liquid processes, the number of surgical open biopsies and curative operations for abscess drainage has declined. Such CT-guided interventions are performed in nearly every organ. Instead of aspiration biopsies, more and more core biopsies are being performed to allow histopathological evaluation and thus allowing targeted therapy. This article is intended to give a general overview of techniques, materials, indications and contraindications. Ultrasound-guided biopsies as well as large bore vacuum biopsies of the breast are not included in this review. (orig.) [de

  17. Liver CT-guided aspirative biopsies

    International Nuclear Information System (INIS)

    Santos, Gilda da Cunha; Carvalho, Leda Viegas de; Chojniak, Rubens; Morini, Sandra Regina

    1996-01-01

    Sixty-eight CT-guided aspirative biopsies of hepatic nodules were performed at A.C. Camargo Hospital, Sao Paulo, Brazil, from 1992 to 1995. The cases were distributed as follow: 44(64.7%) with a positive diagnosis for neoplastic cells, 6(8.8%) with a negative diagnosis, and 14 (20.5%) with insufficient material. Of the positive cases (primary neoplasias and metastases), the cytological diagnosis was achieved in 39 cases. There were 36 cases of carcinoma (7 hepato carcinomas, 18 adenocarcinomas, 1 small cell carcinoma and 10 cases of unspecified differentiation), 2 cases of melanoma and 1 case of melanoma and 1 case of sarcoma. The correlation with histopathological exams showed no false positive cases and concordance between cytological and histopathological diagnosis. The results demonstrate that CT-guided aspirative biopsy of hepatic nodules permits a rapid diagnosis of neoplastic lesions, especially for the evaluation of metastases. (author)

  18. Transthoracic CT-guided biopsy with multiplanar reconstruction image improves diagnostic accuracy of solitary pulmonary nodules

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Hatabu, Hiroto; Takenaka, Daisuke; Imai, Masatake; Ohbayashi, Chiho; Sugimura, Kazuro

    2004-01-01

    Objective: To evaluate the utility of multiplanar reconstruction (MPR) image for CT-guided biopsy and determine factors of influencing diagnostic accuracy and the pneumothorax rate. Materials and methods: 390 patients with 396 pulmonary nodules underwent transthoracic CT-guided aspiration biopsy (TNAB) and transthoracic CT-guided cutting needle core biopsy (TCNB) as follows: 250 solitary pulmonary nodules (SPNs) underwent conventional CT-guided biopsy (conventional method), 81 underwent CT-fluoroscopic biopsy (CT-fluoroscopic method) and 65 underwent conventional CT-guided biopsy in combination with MPR image (MPR method). Success rate, overall diagnostic accuracy, pneumothorax rate and total procedure time were compared in each method. Factors affecting diagnostic accuracy and pneumothorax rate of CT-guided biopsy were statistically evaluated. Results: Success rates (TNAB: 100.0%, TCNB: 100.0%) and overall diagnostic accuracies (TNAB: 96.9%, TCNB: 97.0%) of MPR were significantly higher than those using the conventional method (TNAB: 87.6 and 82.4%, TCNB: 86.3 and 81.3%) (P<0.05). Diagnostic accuracy were influenced by biopsy method, lesion size, and needle path length (P<0.05). Pneumothorax rate was influenced by pathological diagnostic method, lesion size, number of punctures and FEV1.0% (P<0.05). Conclusion: The use of MPR for CT-guided lung biopsy is useful for improving diagnostic accuracy with no significant increase in pneumothorax rate or total procedure time

  19. Technical note: CT-guided biopsy of lung masses using an automated guiding apparatus

    International Nuclear Information System (INIS)

    Chellathurai, Amarnath; Kanhirat, Saneej; Chokkappan, Kabilan; Swaminathan, Thiruchendur S; Kulasekaran, Nadhamuni

    2009-01-01

    Automated guiding apparatuses for CT-guided biopsies are now available. We report our experience with an indigenous system to guide lung biopsies. This system gave results similar to those with the manual technique. Automated planning also appears to be technically easier, it requires fewer number of needle passes, consumes less time, and requires fewer number of check scans

  20. Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: effect on pneumothorax rate in 1,191 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Im [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of); Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Park, Chang Min; Goo, Jin Mo [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University, Cancer Research Institute, Seoul (Korea, Republic of); Lee, Sang Min [Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of)

    2015-07-15

    To investigate the effect of rapid needle-out patient-rollover approach on the incidence of pneumothorax and drainage catheter placement due to pneumothorax in C-arm Cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) of lung lesions. From May 2011 to December 2012, 1227 PTNBs were performed in 1191 patients with a 17-gauge coaxial needle. 617 biopsies were performed without (conventional-group) and 610 with rapid-rollover approach (rapid-rollover-group). Overall pneumothorax rates and incidences of pneumothorax requiring drainage catheter placement were compared between two groups. There were no significant differences in overall pneumothorax rates between conventional and rapid-rollover groups (19.8 % vs. 23.1 %, p = 0.164). However, pneumothorax rate requiring drainage catheter placement was significantly lower in rapid-rollover-group (1.6 %) than conventional-group (4.2 %) (p = 0.010). Multivariate analysis revealed male, age > 60, bulla crossed, fissure crossed, pleura to target distance > 1.3 cm, emphysema along needle tract, and pleural punctures ≥ 2 were significant risk factors of pneumothorax (p < 0.05). Regarding pneumothorax requiring drainage catheter placement, fissure crossed, bulla crossed, and emphysema along needle tract were significant risk factors (p < 0.05), whereas rapid-rollover approach was an independent protective factor (p = 0.002). The rapid needle-out patient-rollover approach significantly reduced the rate of pneumothorax requiring drainage catheter placement after CBCT-guided PTNB. (orig.)

  1. Pericardial Tamponade Following CT-Guided Lung Biopsy

    International Nuclear Information System (INIS)

    Mitchell, Michael J.; Montgomery, Mark; Reiter, Charles G.; Culp, William C.

    2008-01-01

    While not free from hazards, CT-guided biopsy of the lung is a safe procedure, with few major complications. Despite its safety record, however, potentially fatal complications do rarely occur. We report a case of pericardial tamponade following CT-guided lung biopsy. Rapid diagnosis and therapy allowed for complete patient recovery. Physicians who perform this procedure should be aware of the known complications and be prepared to treat them appropriately.

  2. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Heerink, W.J.; Vliegenthart, R. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Radiology, University of Groningen, Groningen (Netherlands); Bock, G.H. de [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen (Netherlands); Jonge, G.J. de [University Medical Center Groningen, Department of Radiology, University of Groningen, Groningen (Netherlands); Groen, H.J.M. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Pulmonary Medicine, University of Groningen, Groningen (Netherlands); Oudkerk, M. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands)

    2017-01-15

    To meta-analyze complication rate in computed tomography (CT)-guided transthoracic lung biopsy and associated risk factors. Four databases were searched from 1/2000 to 8/2015 for studies reporting complications in CT-guided lung biopsy. Overall and major complication rates were pooled and compared between core biopsy and fine needle aspiration (FNA) using the random-effects model. Risk factors for complications in core biopsy and FNA were identified in meta-regression analysis. For core biopsy, 32 articles (8,133 procedures) were included and for FNA, 17 (4,620 procedures). Pooled overall complication rates for core biopsy and FNA were 38.8 % (95 % CI: 34.3-43.5 %) and 24.0 % (95 % CI: 18.2-30.8 %), respectively. Major complication rates were 5.7 % (95 % CI: 4.4-7.4 %) and 4.4 % (95 % CI: 2.7-7.0 %), respectively. Overall complication rate was higher for core biopsy compared to FNA (p < 0.001). For FNA, larger needle diameter was a risk factor for overall complications, and increased traversed lung parenchyma and smaller lesion size were risk factors for major complications. For core biopsy, no significant risk factors were identified. In CT-guided lung biopsy, minor complications were common and occurred more often in core biopsy than FNA. Major complication rate was low. For FNA, smaller nodule diameter, larger needle diameter and increased traversed lung parenchyma were risk factors for complications. (orig.)

  3. Percutaneous CT-guided biopsy of the musculoskeletal system: Results of 2027 cases

    International Nuclear Information System (INIS)

    Rimondi, Eugenio; Rossi, Giuseppe; Bartalena, Tommaso; Ciminari, Rosanna; Alberghini, Marco; Ruggieri, Pietro; Errani, Costantino; Angelini, Andrea; Calabro, Teresa; Abati, Caterina Novella; Balladelli, Alba; Tranfaglia, Cristina; Mavrogenis, Andreas F.; Vanel, Daniel; Mercuri, Mario

    2011-01-01

    Introduction: Biopsy of the musculoskeletal system is useful in the management of bone lesions particularly in oncology but they are often challenging procedures with a significant risk of complications. Computed tomography (CT)-guided needle biopsies may decrease these risks but doubts still exist about their diagnostic accuracy. This retrospective analysis of the experience of a single institution with percutaneous CT-guided biopsy of musculoskeletal lesions evaluates the results of these biopsies for bone lesions either in the appendicular skeleton or in the spine, and defines indications. Materials and methods: We reviewed the results of 2027 core needle biopsies performed over the past 18 years at the authors' institution. The results obtained are subject of this paper. Results: In 1567 cases the correct diagnosis was made with the first CT-guided needle biopsy (77.3% accuracy rate), in 408 cases the sample was not diagnostic and in 52 inadequate. Within 30 days these 408 patients underwent another biopsy, which was diagnostic in 340 cases with a final diagnostic accuracy of 94%. Highest accuracy rates were obtained in primary and secondary malignant lesions. Most false negative results were found in cervical lesions and in benign, pseudotumoral, flogistic, and systemic pathologies. There were 22 complications (18 transient paresis, 3 haematomas, 1 retroperitoneal haematoma) which had no influence on the treatment strategy, nor on patient outcome. Conclusion: This technique is reliable and safe and should be considered nowadays the gold standard for biopsies of the musculoskeletal system.

  4. CT guided transthoracic fine needle aspiration biopsy (TFNAB) of the chest tumours; Transtorakalna biopsja aspiracyjna cienkoiglowa (TBAC) guzow umiejscowionych w klatce piersiowej pod kontrola obrazu tomografii komputerowej

    Energy Technology Data Exchange (ETDEWEB)

    Glowacki, J; Legaszewski, T; Skrzelewski, S; Sraga, W [Katedra i Zaklad Radiologii Lekarskiej i Radiodiagnostyki, Zabrze (Poland); Slaska Akademia Medyczna, Katowice [Poland; Zajecki, W [Katedra i Klinika Chirurgii Klatki Piersiowej, Zabrze (Poland); Slaska Akademia Medyczna, Katowice [Poland; Harasim, J [Katedra i Zaklad Patomorfologii, Zabrze (Poland); Slaska Akademia Medyczna, Katowice [Poland; Polonska, A [Katedra i Klinika Fizjopneumonologii, Zabrze (Poland); Slaska Akademia Medyczna, Katowice [Poland

    2003-07-01

    Tumours spreading within the chest are nowadays diagnosed based on computed tomography (CT). The aim of this paper is to present a few years experience in transthoracic fine needle aspiration biopsy of lung tumours and tumour-like lesions in adjacent tissues and organs during CT examination. To make an accurate diagnosis, the authors performed 124 TFNAB in 116 patients. About 2/3 of the biopsies were performed in patients with a tumour size from 1 to 5 cm in diameter, adjacent or located peripherally to the chest wall. The valuable cellular material, which enabled us to define a type of a disease and to make a final clinical diagnosis, was obtained in nearly 80% of cases. The complications were found in 10 patients (8.6% of all patients). Pneumothorax was found in eight cases and pulmonary bleeding (bleeding into pulmonary parenchyma and bleeding from respiratory duct) in two cases. The authors emphasized the significance of TFNAB in obtaining valuable material for fine spectrum study and discussed the problem of safety related to this procedure. (author)

  5. [Predictive factors of complications during CT-guided transthoracic biopsy].

    Science.gov (United States)

    Fontaine-Delaruelle, C; Souquet, P-J; Gamondes, D; Pradat, E; de Leusse, A; Ferretti, G R; Couraud, S

    2017-04-01

    CT-guided transthoracic core-needle biopsy (TTNB) is frequently used for the diagnosis of lung nodules. The aim of this study is to describe TTNBs' complications and to investigate predictive factors of complications. All consecutive TTNBs performed in three centers between 2006 and 2012 were included. Binary logistic regression was used for multivariate analysis. Overall, 970 TTNBs were performed in 929 patients. The complication rate was 34% (life-threatening complication in 6%). The most frequent complications were pneumothorax (29% included 4% which required chest-tube) and hemoptysis (5%). The mortality rate was 0.1% (n=1). In multivariate analysis, predictive factor for a complication was small target size (AOR=0.984; 95% CI [0.976-0.992]; P<0.001). This predictive factor was also found for occurrence of life-threatening complication (AOR=0.982; [0.965-0.999]; P=0.037), of pneumothorax (AOR=0.987; [0.978-0.995]; P=0.002) and of hemoptysis (AOR=0.973; [0.951-0.997]; P=0.024). One complication occurred in one-third of TTNBs. The proportion of life-threatening complication was 6%. A small lesion size was predictive of complication occurrence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Analysis of diagnositc accuracy with CT-guided percutaneous transthoracic lung biopsy for pulmonary lesions

    International Nuclear Information System (INIS)

    Wang Haiyan; Zhuang Yiping; Zhang Jin; Feng Yong; Zhang Xiao; Xu Lin

    2007-01-01

    Objective: To evaluate the factors which may affect the diagnostic accmracy of CT-guided percutaneous transthoracic lung biopsy for pulmonary lesions. Methods: CT-guided percutaneous transthoracic lung biopsy was performed in 264 patients, all of which were proved by surgical pathology or clinical follow-up. A logistic regression analysis was used to investigate the relationship between the location and the size of the lesions and insertion depth of biopsy needles and the diagnostic accuracy of CT-guided percutaneous transthomcic lung biopsy. The complication rate including pneumatothorax and bleeding rate were record. Results: The diagnostic accuracy was 87.5%. Both the pneumothorax and the bleeding of lesion were 1.9%. The size of lesion was suggested by Logistic regression analysis had a significant influence on the diagnostic accuracy (Wald=12.891, P=0.00034, OR=0.96). Conclusion: CT-guided pereumneous transthoracic lung biopsy has a high diagnostic accuracy for pulmonary lesions. The size of the lesions had significant effect on the diagnostic accuracy. (authors)

  7. CT-guided preoperative needle localization of MRI-detected breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Giagounidis, Elektra M. E-mail: giagounjdis@online.de; Markus, Ruwe; Josef, Luetzeler; Wemer, Audretsch; Mahdi, Rezai; Bernward, Kurtz

    2001-08-01

    To assess the value of accurate preoperative CT-guided needle localization of occult breast lesions, we reviewed a total of 39 needle-directed biopsies of breast tumors in 24 women. The average age was 52.9 years (range 31-67). All lesions were nonpalpable and mammographically, as well as sonographically occult. They were solely seen on MR-images. After demonstrating the suspicious region on CT scans, a hookwire was inserted. The correct position was confirmed by a control scan. The subsequent histopathological examination showed that 28 of the lesions (71.8%) were benign, among them mastopathy, fibrosis, fibroadenoma, papilloma, intramammary lymph node, liponecrosis and epitheliosis. Eleven lesions (28%) were malignant and showed either lobular, ductal or tubular cancer. Our results endorse that CT guided needle localization is a helpful method that allows a precise surgical excision of the suspect area with the removal of a minimal amount of breast tissue.

  8. CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy

    International Nuclear Information System (INIS)

    Stattaus, Joerg; Kuehl, Hilmar; Ladd, Susanne; Schroeder, Tobias; Antoch, Gerald; Baba, Hideo A.; Barkhausen, Joerg; Forsting, Michael

    2007-01-01

    Purpose. Our study aimed to determine the visibility of small liver lesions during CT-guided biopsy and to assess the influence of lesion visibility on biopsy results. Material and Methods. Fifty patients underwent CT-guided core biopsy of small focal liver lesions (maximum diameter, 3 cm); 38 biopsies were performed using noncontrast CT, and the remaining 12 were contrast-enhanced. Visibility of all lesions was graded on a 4-point-scale (0 = not visible, 1 = poorly visible, 2 = sufficiently visible, 3 = excellently visible) before and during biopsy (with the needle placed adjacent to and within the target lesion). Results. Forty-three biopsies (86%) yielded diagnostic results, and seven biopsies were false-negative. In noncontrast biopsies, the rate of insufficiently visualized lesions (grades 0-1) increased significantly during the procedure, from 10.5% to 44.7%, due to needle artifacts. This resulted in more (17.6%) false-negative biopsy results compared to lesions with good visualization (4.8%), although this difference lacks statistical significance. Visualization impairment appeared more often with an intercostal or subcostal vs. an epigastric access and with a subcapsular vs. a central lesion location, respectively. With contrast-enhanced biopsy the visibility of hepatic lesions was only temporarily improved, with a risk of complete obscuration in the late phase. Conclusion. In conclusion, visibility of small liver lesions diminished significantly during CT-guided biopsy due to needle artifacts, with a fourfold increased rate of insufficiently visualized lesions and of false-negative histological results. Contrast enhancement did not reveal better results

  9. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy

    International Nuclear Information System (INIS)

    Khan, M.F.; Straub, R.; Moghaddam, S.R.; Maataoui, A.; Gurung, J.; Thalhammer, A.; Vogl, T.J.; Jacobi, V.; Wagner, T.O.F.; Ackermann, H.

    2008-01-01

    The influence of various variables on the rate of pneumothorax and intrapulmonal hemorrhage associated with computed tomography (CT)-guided transthoracic needle biopsy of the lung were evaluated retrospectivly. One hundred and thirty-three patients underwent CT guided biopsy of a pulmonary lesion. Two patients were biopsied twice. Variables analyzed were lesion size, lesion location, number of pleural needle passes, lesion margin, length of intrapulmonal biopsy path and puncture time. Eighteen-gauge (18G) cutting needles (Trucut, Somatex, Teltow, Germany) were used for biopsy. Pneumothorax occured in 23 of 135 biopsies (17%). Chest tube placement was required in three out of 23 cases of pneumothorax (2% of all biopsies). Pneumothorax rate was significantly higher when the lesions were located in the lung parenchyma compared with locations at the pleura or chest wall (P < 0.05), but all pneumothorax cases which required chest tube treatment occured in lesions located less than 2 cm from the pleura. Longer puncture time led to an increase in pneumothorax rate (P < 0.05). Thirty-seven (27%) out of 135 biopsies showed perifocal hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage and pneumothorax (P < 0.05). Significantly more hemorrhage occured when the pleura was penetrated twice during the puncture (P < 0.05). Lesion size <4 cm is strongly correlated with higher occurence of perifocal hemorrhage (P < 0.05). Lesion margination showed no significant effect on complication rate. CT-guided biopsy of smaller lesions correlates with a higher bleeding rate. Puncture time should be minimized to reduce pneumothorax rate. Passing the pleura twice significantly increases the risk of hemorrhage. Intrapulmonal biopsy paths longer than 4 cm showed significantly higher numbers of perifocal hemorrhage as well as pneumothorax. (orig.)

  10. CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

    Energy Technology Data Exchange (ETDEWEB)

    Billich, Christian; Brenner, Gerhard; Schmidt, Stefan A.; Brambs, Hans-Juergen; Pauls, Sandra [University of Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany); Muche, Rainer [University of Ulm, Institute of Biometrics, Ulm (Germany); Krueger, Stefan [University of Ulm, Department of Internal Medicine, Ulm (Germany)

    2008-06-15

    This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n = 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P = 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax. (orig.)

  11. CT-guided lung biopsy: incidence of pneumothorax after instillation of NaCl into the biopsy track

    International Nuclear Information System (INIS)

    Billich, Christian; Brenner, Gerhard; Schmidt, Stefan A.; Brambs, Hans-Juergen; Pauls, Sandra; Muche, Rainer; Krueger, Stefan

    2008-01-01

    This study was conducted to evaluate whether instillation of NaCl 0.9% solution into the biopsy track reduces the incidence of pneumothoraces after CT-guided lung biopsy. A total of 140 consecutive patients with pulmonary lesions were included in this prospective study. All patients were alternatingly assigned to one of two groups: group A in whom the puncture access was sealed by instillation of NaCl 0.9% solution during extraction of the guide needle (n 70) or group B for whom no sealing was performed (n = 70). CT-guided biopsy was performed with a 18-G coaxial system. Localization of lesion (pleural, peripheral, central), lesion size, needle-pleural angle, rate of pneumothorax and alveolar hemorrhage were evaluated. In group A, the incidence of pneumothorax was lower compared to group B (8%, 6/70 patients vs. 34%, 24/70 patients; P < 0.001). All pneumothoraces occurred directly post punctionem after extraction of the guide needle. One patient in group A and eight patients in group B developed large pneumothoraces requiring chest tube placement (P 0.01). The frequency of pneumothorax was independent of other variables. After CT-guided biopsy, instillation of NaCl 0.9% solution into the puncture access during extraction of the needle significantly reduces the incidence of pneumothorax. (orig.)

  12. The clinical application of percutaneous auto-biopsy of small lung nodular under CT-Guided

    International Nuclear Information System (INIS)

    Zhou Yuanmin; Ye Genxin; Zhang Chenghui; Wang Yu; Chen Wei

    2008-01-01

    Objective: To evaluated the clinical value of technology of petcutaneous auto-biopsy of small lung nodular under CT- Guide. Methods: 44 cases of small single lung nodular were underwent biopsy with 20G auto-biopsy needle under CT guidance. All cases underwent pathological diagnosis. Results: All 44 cases were punctured successfully. 41 cases were succeeded in first puncturation. The success ratio was 93.02%. Other 3 cases needed second puncturation. 39 of 44 cases pathological diagnosis were malignant. Only 1 case could not be diagnosed. 6 patients had lightly pneumatothorax after biopsy. 10 cases had mild pneumonorrhagia after biopsy. 2 of them had haemptysis. All cases had no complication such as infection, needle track implantation. Conclusion: The technology of CT Guidance auto-biopsy of small lung nodular is safe and effective; it has extreme diagnostic ratio and less complication. (authors)

  13. Study of CT-guided percutaneous biopsy for the spine lesions

    International Nuclear Information System (INIS)

    Zhang Ji; Wu Chungen; Cheng Yongde; Zhu Xuee; Gu Yifeng; Zhang Huijian

    2008-01-01

    Objective: To determine the successful rate, diagnostic accuracy and clinical usefulness of CT-guided percutaneous biopsy for the spine lesions. Methods: Eight-five patients (61 outpatients, 24 ward patients)underwent CT-guided percutaneous biopsy for the spine lesion. The imaging appearance of spinal lesions were lytic in 57 cases, osteosclerotic in 19 cases, and mixed in 9 cases. Biopsy specimens were sent for cytologic and histologic analysis in order to correct diagnosis. Bacterial studies were performed when ever infection was suspected. Results: The localization of puncture biopsy needle inside the spinal lesions, was conformed by computed tomography including 3 cervical, 26 thoracic, 37 lumbar, and 19 sacral lesions. Biopsy specimens included bone (29 cases), soft tissue (5 cases), mixed tissue (47 cases )and no specimen be obtained(4 cases). An adequate specimen for pathologic examination was obtained in 81 biopsies (95%). The pathologic examinations revealed 44 metastases, 17 primary bone neoplasms, 18 infections (included tuberculosis)and 2 normal tissues of vertebral body. The diagnostic accuracy reached 97.5% (79 of 81 patients). Conclusions: CT-guided percutaneous biopsy is an important tool in the evaluation of spinal lesions, providing accurate localization, less trauma and reliable pathologic diagnosis and worthwhile to be the routine before vertebroplasy. (authors)

  14. CT-guided stereotaxic biopsy in 104 cases of brain tumors

    International Nuclear Information System (INIS)

    Niizuma, Hiroshi; Nakasato, Nobukazu; Jokura, Hidehumi; Otsuki, Taisuke; Katakura, Ryuichi; Suzuki, Jiro

    1988-01-01

    Biopsy of suspected brain tumor was performed on 104 cases using Leksell's CT-guided stereotaxic system. The entire operation was performed in the CT room. A Backlund's spiral biopsy needle was advanced to the target point in a stepwise fashion and two to nine tissue samples were obtained from one to three biopsy tracks. Tissue sampling was impossible in two cases because the tumors were too hard for biopsy needle to advance. Also, sampling was sometimes difficult in the case of soft and necrotic tumor, cystic tumor, already treated (irradiated) tumor and the lesion including old blood clot. After the biopsy, minimal bleeding occurred in nine cases, however, stopped within 10 minutes by controlling the blood pressure. A minimum sized hematoma was visible on the postoperative CT in four cases. Postoperative neurological deterioration was seen in two cases. One case was transient and the other seemed to be in his natural course. Anyway, there were neither cases of operative mortality nor severely complicated cases in these series. Useful pathological diagnosis was possible in 83 cases (80 %). Accurate diagnosis was not possible in the remaining 21 cases, however, their histological datum such as necrosis, blood clot, and so on were very useful to estimate the lesions. In summary, accurate diagnosis rate of CT-guided stereotaxic needle biopsy was 80 %. However, it appeared to be a safe and useful procedure in the diagnosis of intracranial mass lesions. (author)

  15. CT-guided procedures: evaluation of a phantom system to teach accurate needle placement

    International Nuclear Information System (INIS)

    Dimmick, S.; Jones, M.; Challen, J.; Iedema, J.; Wattuhewa, U.; Coucher, J.

    2007-01-01

    Aim: To evaluate the use of a phantom system to help teach the basic techniques of accurate CT-guided needle placement, thereby avoiding the risks associated with teaching on patients. Materials and Methods: Gelatine phantoms with five, 1.9 cm embedded spherical wooden targets were constructed. Four trainee operators performed 15 simulated biopsy procedures on the targets (series one) and repeated identical procedures 2 weeks later (series two). Statistical analysis of accuracy of needle placement and subject confidence were performed. Results: Significant sequential improvement in axial plane angular error was noted with the average error decreasing by 0.33 degrees after every five procedures performed (95% CI: -0.58 to -0.08, p = 0.01). Operator confidence indicated significant improvement both within each series and from series one to series two (95% CI: 0.08 to 1.17, p = 0.025 and 95% CI: 0.00 to 0.58, p = 0.05) respectively. However, variability in operator performance made statistically significant improvement in other variables unproven. Conclusion: Despite the study comprising a relatively small number of participants and procedures, it clearly demonstrated the effectiveness of teaching operators to perform CT-guided procedures using a phantom system. Needle placement accuracy significantly improved, with a reduction in axial angular error, and improved operator confidence without the risks associated with training on patients. Three of the operators in this study had never performed a CT-guided procedure previously, and their proficiency, after a relatively short but intense period of training, was impressive. The use of phantoms should be considered routinely for basic training of CT-guided needle placement

  16. Automatic path proposal computation for CT-guided percutaneous liver biopsy.

    Science.gov (United States)

    Helck, A; Schumann, C; Aumann, J; Thierfelder, K; Strobl, F F; Braunagel, M; Niethammer, M; Clevert, D A; Hoffmann, R T; Reiser, M; Sandner, T; Trumm, C

    2016-12-01

    To evaluate feasibility of automatic software-based path proposals for CT-guided percutaneous biopsies. Thirty-three patients (60 [Formula: see text] 12 years) referred for CT-guided biopsy of focal liver lesions were consecutively included. Pre-interventional CT and dedicated software (FraunhoferMeVis Pathfinder) were used for (semi)automatic segmentation of relevant structures. The software subsequently generated three path proposals in downward quality for CT-guided biopsy. Proposed needle paths were compared with consensus proposal of two experts (comparable, less suitable, not feasible). In case of comparable results, equivalent approach to software-based path proposal was used. Quality of segmentation process was evaluated (Likert scale, 1 [Formula: see text] best, 6 [Formula: see text] worst), and time for processing was registered. All biopsies were performed successfully without complications. In 91 % one of the three automatic path proposals was rated comparable to experts' proposal. None of the first proposals was rated not feasible, and 76 % were rated comparable to the experts' proposal. 7 % automatic path proposals were rated not feasible, all being second choice ([Formula: see text]) or third choice ([Formula: see text]). In 79 %, segmentation at least was good. Average total time for establishing automatic path proposal was 42 [Formula: see text] 9 s. Automatic software-based path proposal for CT-guided liver biopsies in the majority provides path proposals that are easy to establish and comparable to experts' insertion trajectories.

  17. Clinical application of CT-guided percutaneous puncturing biopsy of subcarinal lymph node

    International Nuclear Information System (INIS)

    Yuan Xiaodong; Wang Jianhua; Zuo Changjing; Tian Jianming

    2011-01-01

    Objective: To discuss the safety and clinical significance of CT-guided percutaneous puncturing biopsy of subcarinal lymph node. Methods: During the period of July 2006-July 2010, CT-guided percutaneous puncturing biopsy of subcarinal lymph node was carried out in 17 patients (11 males and 6 females, with an average age of 54 years) with enlarged subcarinal lymph nodes. The clinical data were retrospectively analyzed. Immediately after the puncturing procedure was completed, CT scanning was performed to observe if there any complications and to evaluate the safety of puncturing biopsy. Biopsy specimens were sent for pathological examination to assess the puncturing accuracy and to make the pathologic diagnosis. The clinical usefulness of this technique was evaluated. Results: Of the total 17 cases, successful puncturing into the enlarged subcarinal lymph nodes with single procedure was achieved in 14 and sufficient tissue sample was obtained. The biopsy failed in three cases at initial puncturing procedure as the needle could not be placed into the enlarged subcarinal lymph nodes, the puncturing biopsy had to given up in two patients because of hemoptysis and in another patient the second puncturing biopsy performed one week later was successful. The total technical successful rate was 88.2% (15/17). Of the fifteen cases with successful puncturing, definitive pathological diagnosis was obtained in 13 and the diagnosis was uncertain in the remaining two, with a diagnosis positive rate of 86.7% (13/15). Pathologically, the diagnoses included metastatic lymphadenopathy from lung cancer (n=10), proliferative inflammatory lymphadenopathy (n=2) and tuberculous enlargement of lymph nodes (n=1). Complications occurred in 4 patients (23.5%, 4/17), which mainly were pneumothorax and pulmonary hemorrhage. Conclusion: With high successful rate and diagnostic accuracy, CT-guided percutaneous puncturing biopsy of subcarinal lymph node is a safe and effective technique if the

  18. CT-guided percutaneous transthoracic aspiration biopsy of lung lesions: factors influencing the diagnostic accuracy

    International Nuclear Information System (INIS)

    Huang Zhenguo; Zhang Xuezhe; Wang Wu

    2006-01-01

    Objective: To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods: CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up. Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors (benignancy or malignancy, size, location, depth, presence of cavity), procedure factors (laser-guidance, position of patient) and patient-related factors (sex, age, presence of emphysema); with the accuracy of the diagnosis. Results: 1)289 lesions were diagnosed as malignant ones and 146 as benign ones. The accuracy of CT-guided biopsy was 83.4%(363/435). Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were 88.9%(257/289) and 72.6%(106/146), respectively (χ 2 =18.71, P=0.00002). Laser-group was superior to non-laser group (88.4% versus 80.9%, respectively, χ 2 =4.00, P=0.0456). Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were 3.78±1.64 cm and 3.02±1.26 cm, respectively (F=13.79, P=0.0002). 2)Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses (Wald χ 2 =14.01, P=0.0002) and using laser-guidance(Wald χ 2 =3.92, P=0.0477) were significantly associated with the diagnostic accuracy. Conclusions: Final correct diagnoses (benign, malignant) are closely related to the application of laser-guidance for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy. (authors)

  19. Effects of a Multidisciplinary Approach to Improve Volume of Diagnostic Material in CT-Guided Lung Biopsies.

    Science.gov (United States)

    Ferguson, Philip E; Sales, Catherine M; Hodges, Dalton C; Sales, Elizabeth W

    2015-01-01

    Recent publications have emphasized the importance of a multidisciplinary strategy for maximum conservation and utilization of lung biopsy material for advanced testing, which may determine therapy. This paper quantifies the effect of a multidisciplinary strategy implemented to optimize and increase tissue volume in CT-guided transthoracic needle core lung biopsies. The strategy was three-pronged: (1) once there was confidence diagnostic tissue had been obtained and if safe for the patient, additional biopsy passes were performed to further increase volume of biopsy material, (2) biopsy material was placed in multiple cassettes for processing, and (3) all tissue ribbons were conserved when cutting blocks in the histology laboratory. This study quantifies the effects of strategies #1 and #2. This retrospective analysis comparing CT-guided lung biopsies from 2007 and 2012 (before and after multidisciplinary approach implementation) was performed at a single institution. Patient medical records were reviewed and main variables analyzed include biopsy sample size, radiologist, number of blocks submitted, diagnosis, and complications. The biopsy sample size measured was considered to be directly proportional to tissue volume in the block. Biopsy sample size increased 2.5 fold with the average total biopsy sample size increasing from 1.0 cm (0.9-1.1 cm) in 2007 to 2.5 cm (2.3-2.8 cm) in 2012 (Pstrategy to CT-guided lung biopsies was effective in significantly increasing tissue volume and number of blocks available for advanced diagnostic testing.

  20. Enabling image fusion for a CT guided needle placement robot

    Science.gov (United States)

    Seifabadi, Reza; Xu, Sheng; Aalamifar, Fereshteh; Velusamy, Gnanasekar; Puhazhendi, Kaliyappan; Wood, Bradford J.

    2017-03-01

    Purpose: This study presents development and integration of hardware and software that enables ultrasound (US) and computer tomography (CT) fusion for a FDA-approved CT-guided needle placement robot. Having real-time US image registered to a priori-taken intraoperative CT image provides more anatomic information during needle insertion, in order to target hard-to-see lesions or avoid critical structures invisible to CT, track target motion, and to better monitor ablation treatment zone in relation to the tumor location. Method: A passive encoded mechanical arm is developed for the robot in order to hold and track an abdominal US transducer. This 4 degrees of freedom (DOF) arm is designed to attach to the robot end-effector. The arm is locked by default and is released by a press of button. The arm is designed such that the needle is always in plane with US image. The articulated arm is calibrated to improve its accuracy. Custom designed software (OncoNav, NIH) was developed to fuse real-time US image to a priori-taken CT. Results: The accuracy of the end effector before and after passive arm calibration was 7.07mm +/- 4.14mm and 1.74mm +/-1.60mm, respectively. The accuracy of the US image to the arm calibration was 5mm. The feasibility of US-CT fusion using the proposed hardware and software was demonstrated in an abdominal commercial phantom. Conclusions: Calibration significantly improved the accuracy of the arm in US image tracking. Fusion of US to CT using the proposed hardware and software was feasible.

  1. Extrapeural locating method: significance in CT-guided transthoracic pulmonary biopsy

    International Nuclear Information System (INIS)

    Tang Guangjian; Wang Rengui; Liu Jianxin; Sun Jingtao

    2008-01-01

    Objective: To evaluate the usefulness of extrapleural locating method in CT-guided transthoracic pulmonary biopsy to prevent or reduce the size of peumothorax. Methods: One hundred and fifteen cases of CT-guided transthoracic pulmonary biopsy with the pulmonary lesions not in direct contact with the pleura were selected. Of 115 cases, 46 were performed with extrapleural locating method (EPL) and 69 cases with lesion edge locating method (LEL). Taking the maximum distance between the partial and visceral pleura (MPVD) measured on the CT image after the procedure as the index of the volume of pneumothorax. The incidence and volume of pneumothorax of both groups were compared and statistically analysed with R x C Chi-Square test. The retention time of the biopsy needle in the lung parenchyma of the two group was documented and the average time was calculated in each group. Results: The incidence of pneumothorax was 45.7% (21/46), median 0.4 cm with EPL group, and 66.7% (46/69) and median 0.3cm with LEL group. When the distance between the lesion and pleura was equal or smaller than 2 cm (≤2cm), the incidence of pneumothorax was 39.4% (13/33) with EPL group and 73.2% (30/41) with LEL group, and the difference of incidence and volume of the pneumothorax between two groups was statistically significant(χ 2 =9.981, P=0.019). When the distance was larger than 2 cm (>2 cm), the incidence and volume of pneumothorax between two groups were not significant statistically. The average retention time of the biopsy needle in the lung parenchyma was (7.2 ± 1.8) s with EPL group and (58.3 ± 11.6) s with LEL group. Conclusion: The extrapleural locating method can reduce effectively the retention time of the biopsy needle in the lung parenchyma and the incidence and volume of pneumothorax in CT-guided transthoracic pulmonary biopsy. (authors)

  2. Application of CT-guided percutaneous thyroid biopsy in basic study of interventional therapy for Graves disease

    International Nuclear Information System (INIS)

    Yi Genfa; Zhao Wei; Hu Jihong; Jin Cangzheng; Yang Huiying

    2007-01-01

    Objective: To evaluate the value of application of CT-guided percutaneous thyroid biopsy in basic study of interventional treatment for Graves disease. Methods: Fifteen patients of hyperthyroidism caused by Graves' disease had been undertaken transcathter arterial embolizsation with PVA micropheres including 52 core needle biopsy(CNB)of pre-or post-interventional procedure. All procedures were divided into 2 groups according to the size of the thyroid enlargement: (1) II degree enlargement (n=19)under palpation puncture. (2) No enlargement or under II degree enlargement (n=33)with palpation and CT-guided puncture. Results: In group (1), 17 of the 19 procedures with palpation puncture were succeeded, reaching a successful rate of 89.5%. For group (2), the successful rate of CT-guided puncture was 91.7%. The difference between the successful rate of two groups showed statistical significance (P<0.05). No complication occurred during procedures in all cases. Conclusions: CT-guided thyroid core needle biopsy is an accurate, safe and high successful procedure providing the basic study for post-interventional treatment of Graves disease. (authors)

  3. Improved transvenous liver biopsy needle

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Matzen, P; Christoffersen, P

    1979-01-01

    A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle...... should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver....

  4. Results and complications of CT-guided biopsy with CT fluoroscopy

    International Nuclear Information System (INIS)

    Saika, Yoshinori; Ogura, Yasuharu; Doi, Kenji; Misaki, Toshimasa; Shimizu, Masashi; Narabayashi, Isamu

    2002-01-01

    We studied the results and complications of CT-guided biopsy with CT fluoroscopy performed 66 lesions in 64 patients from March 1999 to February 2001. In addition to the conventional procedure of CT-guided biopsy, we use CT fluoroscopy for confirmation of the location of the tip of the biopsy needle and the accurate contact, in some cases, at the time of puncturing. Examination results showed malignancy in 36 lesions and benign findings in 30 lesions. The sensitivity was 85.7%, specificity was 100.0%, and accuracy was 90.9%. Pneumothorax occurred in 20 out of 64 patients (31.3%). In a study on 26 small lesions (≤2 cm) in 25 patients, the sensitivity was 81.8%, specificity was 100.0%, accuracy was 92.3%. Pneumothorax occurred in 12 out of 25 patients (48.0%), more frequently than in patients with large lesions. In a study on 6 false negative cases, they tended to be intrapulmonary on location, small in diameter, and far from the skin puncture point. Examination results were satisfactory, especially in terms of accuracy in small lesions (≤2 cm). However, when the lesions were small, pneumothorax occurred frequently (48.0%). (author)

  5. Prostate biopsy after ano-rectal resection: value of CT-guided trans-gluteal biopsy

    International Nuclear Information System (INIS)

    Cantwell, Colin P.; Hahn, Peter F.; Gervais, Debra A.; Mueller, Peter R.

    2008-01-01

    We describe our single-institutional experience with computed tomography (CT)-guided percutaneous transgluteal biopsy of the prostate in patients in whom transrectal ultrasound-guided biopsy is precluded by prior ano-rectal resection. Between March 1995 and April 2007, 22 patients had 34 prostate biopsies (mean age 68; mean PSA 29 ng/ml; mean follow-up 6.1 years). The charts of patients who had transgluteal biopsy were reviewed for demographic, complications and pathology. Ninety-five percent (21/22) of primary biopsies were diagnostic. Of the 21 diagnostic biopsies, 11 were positive for prostate cancer and ten were definitive benign samples. Seventy-three percent (8/11) of the patients had progressive PSA elevation that mandated 11 further prostate biopsies. Six patients had a second biopsy, one patient had a third and one patient had a fourth biopsy. Among patients who had serial biopsies, 38% (3/8) had prostate cancer. No complications or death occurred. A malignant biopsy was not significantly associated with core number (P = 0.58) or a high PSA level (P 0.15). CT-guided transgluteal biopsy of the prostate is safe and effective. (orig.)

  6. Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, Jane D., E-mail: janecunningham0708@gmail.com; McCusker, Mark W.; Power, Sarah; PearlyTi, Joanna; Thornton, John; Brennan, Paul; Lee, Michael J.; O’Hare, Alan; Looby, Seamus [Beaumont Hospital, Department of Radiology (Ireland)

    2015-04-15

    PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

  7. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    International Nuclear Information System (INIS)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P.; Sun, H.H.; Jiang, Y.H.

    2011-01-01

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  8. Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hao, D.J.; He, B.R.; Liu, T.J.; Zhao, Q.P. (Dept. of Spinal Surgery, Xian Red Cross Hospital, Xian Shaanxi (China)), email: zqpddn1@gmail.com; Sun, H.H. (Dept. of Orthopaedic, Tangdu Hospital, Fourth Military Medical Univ., Xian Shaanxi (China)); Jiang, Y.H. (Dept. of Radiology, Xian Red Cross Hospital, Xian Shaanxi (China))

    2011-11-15

    Background. Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. Purpose. To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. Material and Methods. In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Dept. of Spinal Surgery, Xian Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. Results. The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). Conclusion. Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features

  9. The contribution of CT-guided transthoracic lung biopsy to the diagnosis of organising pneumonia.

    Science.gov (United States)

    Metzger, F; Pernet, D; Manzoni, P; Ranfaing, E; Dalphin, J-C

    2010-09-01

    Organising pneumonia is a pulmonary disease with variable clinical and radiological features and with many differential diagnoses. Diagnosis is based on histology obtained by either transbronchial or surgical lung biopsy but these techniques have several disadvantages. The aim of this study was to evaluate the diagnostic yield of CT-guided transthoracic lung biopsy in organising pneumonia and to compare it to the usual diagnostic tools. Six cases of organising pneumonia diagnosed with CT-guided lung biopsy are reported and discussed. The role of CT-guided lung biopsy in the diagnosis of organising pneumonia was also reviewed in the literature. CT-guided transthoracic lung biopsies provided a higher rate of adequate samples than transbronchial biopsies (92-100% versus 77-86%). The samples were larger, which reduced the risks of misdiagnosis and increased the diagnostic yield (88-97% versus 26-55% in pulmonary nodules and 42-100% versus 66-75% in diffuse pulmonary disease). Complications were rare and generally not serious. CT-guided transthoracic lung biopsy may be considered in place of transbronchial biopsy in the diagnosis of organising pneumonia. Surgical lung biopsy remains the gold standard method for diagnosis. Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  10. PET/CT-guided biopsies of metabolically active bone lesions: applications and clinical impact

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, Bernd; Wartenberg, Jan; Weitzel, Thilo; Krause, Thomas [Bern University Hospital and University of Bern, Department of Nuclear Medicine, Inselspital, Bern (Switzerland); Wiskirchen, Jakub [Bern University Hospital and University of Bern, Department of Nuclear Medicine, Inselspital, Bern (Switzerland); University Hospital Tuebingen, Department of Radiology, Neuroradiology, and Nuclear Medicine, Tuebingen (Germany); Schmid, Ralph A. [Bern University Hospital and University of Bern, Department of Thoracic Surgery, Inselspital, Bern (Switzerland); Mueller, Michel D. [Bern University Hospital and University of Bern, Department of Obstetrics and Gynaecology, Inselspital, Bern (Switzerland)

    2010-11-15

    In a minority of cases a definite diagnosis and stage grouping in cancer patients is not possible based on the imaging information of PET/CT. We report our experience with percutaneous PET/CT-guided bone biopsies to histologically verify the aetiology of hypermetabolic bone lesions. We retrospectively reviewed the data of 20 consecutive patients who underwent multimodal image-guided bone biopsies using a dedicated PET/CT system in a step-by-step technique. Technical and clinical success rates of PET/CT-guided biopsies were evaluated. Questionnaires were sent to the referring physicians to assess the impact of biopsies on patient management and to check the clinical need for PET/CT-guided biopsies. Clinical indications for biopsy were to histologically verify the aetiology of metabolically active bone lesions without a morphological correlate confirming the suspicion of metastases in 15 patients, to determine the origin of suspected metastases in 3 patients and to evaluate the appropriateness of targeted therapy options in 2 patients. Biopsies were technically successful in all patients. In 19 of 20 patients a definite histological diagnosis was possible. No complications or adverse effects occurred. The result of PET/CT-guided bone biopsies determined a change of the planned treatment in overall 56% of patients, with intramodality changes, e.g. chemotherapy with palliative instead of curative intent, and intermodality changes, e.g. systemic therapy instead of surgery, in 22 and 50%, respectively. PET/CT-guided bone biopsies are a promising alternative to conventional techniques to make metabolically active bone lesions - especially without a distinctive morphological correlate - accessible for histological verification. PET/CT-guided biopsies had a major clinical impact in patients who otherwise cannot be reliably stage grouped at the time of treatment decisions. (orig.)

  11. CT-guided percutaneous spine biopsy in suspected infection or malignancy. A study of 214 patients

    International Nuclear Information System (INIS)

    Rehm, J.; Veith, S.; Kauczor, H.U.; Weber, M.A.; Akbar, M.

    2016-01-01

    To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. The accuracy was 94.4% for histopathological analysis and 97.7% for microbiological analysis. In 25% of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69%/78%. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81%/44%. In 52% of all cases, the biopsy result changed subsequent patient management. Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

  12. CT-guided percutaneous spine biopsy in suspected infection or malignancy. A study of 214 patients

    Energy Technology Data Exchange (ETDEWEB)

    Rehm, J.; Veith, S.; Kauczor, H.U.; Weber, M.A. [Heidelberg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Akbar, M. [Heidelberg Univ. (Germany). Dept. of Orthopaedic Surgery and Rehabilitation Medicine

    2016-12-15

    To retrospectively determine the effectiveness and accuracy of CT-guided percutaneous biopsy of malignant and inflammatory bone lesions of the spine and to assess the reliability of pre-biopsy CT and MRI. 214 patients with lesions of the spine, which were suspicious either for being malignant or inflammatory, underwent CT-guided biopsy for pathological and/or microbiological detection. Biopsy samples were sent for histological examination in 128/214 patients, for microbiological analysis in 17/214 patients and for both analyses in 69/214 patients. Retrospectively, the diagnostic accuracy and sensitivity/specificity of the pre-interventional imaging (CT and MRI) were determined. In addition, the influence of the biopsy on subsequent patient management was assessed. The accuracy was 94.4% for histopathological analysis and 97.7% for microbiological analysis. In 25% of cases the microbiological analysis revealed an underlying pathogen that was not significantly affected by pre-biopsy antibiotic therapy. The sensitivity/specificity of the pre-biopsy cross-sectional imaging concerning suspected malignancy was 69%/78%. For suspected infection, the sensitivity/specificity of pre-biopsy imaging was 81%/44%. In 52% of all cases, the biopsy result changed subsequent patient management. Percutaneous CT-guided spine biopsy is a useful and reliable diagnostic procedure to establish a definitive diagnosis but with a relatively low yield of microorganisms in the case of infection.

  13. Systemic Air Embolism After CT-guided Lung Biopsy

    Science.gov (United States)

    2017-11-27

    Patients Who Underwent Percutaneous Lung Biopsy Under CT Guidance; Patients Who Presented Systemic Air Embolism After Percutaneous Lung Biopsy Under CT Guidance Depicted at the Time of the Procedure on a Whole Thoracic CT

  14. Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique

    International Nuclear Information System (INIS)

    Anzidei, Michele; Argiro, Renato; Porfiri, Andrea; Boni, Fabrizio; Zaccagna, Fulvio; Napoli, Alessandro; Leonardi, Andrea; Bezzi, Mario; Catalano, Carlo; Anile, Marco; Venuta, Federico; Vitolo, Domenico; Saba, Luca; Longo, Flavia

    2015-01-01

    Evaluate the performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique. One hundred patients referred for CT-guided lung biopsy were randomly assigned to group A (robot-assisted procedure) or group B (conventional procedure). Size, distance from entry point and position in lung of target lesions were evaluated to assess homogeneity differences between the two groups. Procedure duration, dose length product (DLP), precision of needle positioning, diagnostic performance of the biopsy and rate of complications were evaluated to assess the clinical performance of the robotic system as compared to the conventional technique. All biopsies were successfully performed. The size (p = 0.41), distance from entry point (p = 0.86) and position in lung (p = 0.32) of target lesions were similar in both groups (p = 0.05). Procedure duration and radiation dose were significantly reduced in group A as compared to group B (p = 0.001). Precision of needle positioning, diagnostic performance of the biopsy and rate of complications were similar in both groups (p = 0.05). Robot-assisted CT-guided lung biopsy can be performed safely and with high diagnostic accuracy, reducing procedure duration and radiation dose in comparison to the conventional manual technique. (orig.)

  15. Preliminary clinical experience with a dedicated interventional robotic system for CT-guided biopsies of lung lesions: a comparison with the conventional manual technique

    Energy Technology Data Exchange (ETDEWEB)

    Anzidei, Michele; Argiro, Renato; Porfiri, Andrea; Boni, Fabrizio; Zaccagna, Fulvio; Napoli, Alessandro; Leonardi, Andrea; Bezzi, Mario; Catalano, Carlo [University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences - Radiology - Sapienza, Rome (Italy); Anile, Marco; Venuta, Federico [University of Rome, Department of Thoracic Surgery - Sapienza, Rome (Italy); Vitolo, Domenico [University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences - Pathology - Sapienza, Rome (Italy); Saba, Luca [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, Monserrato (Italy); Longo, Flavia [University of Rome, Department of Radiological, Oncological and Anatomopathological Sciences - Oncology - Sapienza, Rome (Italy)

    2015-05-01

    Evaluate the performance of a robotic system for CT-guided lung biopsy in comparison to the conventional manual technique. One hundred patients referred for CT-guided lung biopsy were randomly assigned to group A (robot-assisted procedure) or group B (conventional procedure). Size, distance from entry point and position in lung of target lesions were evaluated to assess homogeneity differences between the two groups. Procedure duration, dose length product (DLP), precision of needle positioning, diagnostic performance of the biopsy and rate of complications were evaluated to assess the clinical performance of the robotic system as compared to the conventional technique. All biopsies were successfully performed. The size (p = 0.41), distance from entry point (p = 0.86) and position in lung (p = 0.32) of target lesions were similar in both groups (p = 0.05). Procedure duration and radiation dose were significantly reduced in group A as compared to group B (p = 0.001). Precision of needle positioning, diagnostic performance of the biopsy and rate of complications were similar in both groups (p = 0.05). Robot-assisted CT-guided lung biopsy can be performed safely and with high diagnostic accuracy, reducing procedure duration and radiation dose in comparison to the conventional manual technique. (orig.)

  16. CT-guided biopsy: diagnostic relevance, therapeutic consequences and economic aspects

    International Nuclear Information System (INIS)

    Schwarzenberg, H.; Mueller-Huelsbeck, S.; Link, J.; Brossmann, J.; Fahl, M.; Quirin, A.; Heller, M.

    1996-01-01

    Purpose: To evaluate the diagnostic and clinical relevance and therapeutic consequences of CT-guided biopsy with regard to economic aspects. Methods: 213 CT-guided biopsies in 190 were evaluated. All information regarding patient referral, reason for request, body region, underlying diagnosis, and clinical consequences were registered over a period of 22.2±9.4 month. Results: Patient referral to biopsy was mainly from the departments of surgery, internal medicine, and radiotherapy with the question of tumor and metastasis. Less than 5% of biopsies were performed in outpatients. Main regions were the lung (39%), the abdomen (35%), and the skeleton (11%). Biopsy and surgical histology corresponded in 73%. Largest diagnosis groups were benign unspecific tissues or other benign lesions in 24%. As a result of CTP no further procedures necessary in 22.5%. Follow-up studies or conservative treatment were indicated in 11.3%. Surgical procedures were needed in only 15.5%. There was only one complication requiring therapy. Conclusion: CT-guided biopsy is a safe procedure, which helps to avoid unnecessary cost-intensive diagnostics and surgical treatment. If CTP is performed early and in outpatients residence time in the hospital is reduced and thus money is saved. (orig.) [de

  17. Dynamic telecytologic evaluation of imprint cytology samples from CT-guided lung biopsies: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, Helmut [Otto Wagner Hospital, Department of Radiology, Vienna (Austria); Medical University of Vienna, Department of Radiology, Vienna (Austria); Medical University of Vienna, Vienna General Hospital, Department of Radiology, Vienna (Austria); Hoffmann, Elisabeth; Schober, Ewald; Mostbeck, Gerhard [Otto Wagner Hospital, Department of Radiology, Vienna (Austria); Bernhardt, Klaus; Schalleschak, Johann [Otto Wagner Hospital, Department of Laboratory Medicine, Vienna (Austria); Rowhani, Marcel [Otto Wagner Hospital, Department of Respiratory and Critical Care Medicine, Vienna (Austria); Weber, Michael [Medical University of Vienna, Department of Radiology, Vienna (Austria)

    2011-09-15

    This study assessed the feasibility of telecytological evaluation of samples from CT-guided lung biopsies using a dynamic telecytological system in which the microscope was operated by personnel from the radiology department at the site of the biopsy and a cytologist off-site diagnosed the biopsy sample. 45 imprint samples from CT-guided biopsies of lung lesions were reviewed by two cytologists using a telecytological microscope (Olympus BX51, Tokyo, Japan). The telecytological microscope was operated by one radiologist and one radiology technician. The cytological samples were classified by a cytologist into four categories: benign, malignant, atypical cells of undetermined significance, and non-diagnostic. The results were compared with those of a previous consensus reading of two independent cytologists (gold standard). When the radiologist was operating the microscope, the diagnostic accuracy was 100% as both cytologists came to the correct diagnosis in all samples. When the technician operated the microscope, two diagnoses of cyotologist 1 differed from the gold standard. Thus, the accuracy for the technician was 95.56%. Telecytological evaluation of imprint samples from CT-guided lung biopsies is feasible because it can be performed with high diagnostic accuracy if personnel from the radiology department operate the microscope. (orig.)

  18. Computed tomography-guided percutaneous core needle biopsy of deep seated bone lesions in two dogs

    International Nuclear Information System (INIS)

    Mori, T.; Sakaida, M.; Yamada, M.; Akiyama, H.; Takai, Y.; Sakai, H.; Maruo, K.

    2006-01-01

    Computed Tomography (CT)-guided percutaneous core needle biopsies were undertaken for the diagnosis of osteosarcoma in the pelvis (case 1) and myeloma (case 2) in the seventh lumber vertebra which were difficult to targeted by palpation, ultrasound or fluoroscopy. In both cases, enough tissue for pathological diagnosis were obtained without any complication. CT-guided biopsy was thought to be a safe, easy and effective technique for the evaluation of the deep seated bone lesion

  19. Painful percutaneous transthoracic needle biopsy of Schwannoma: a case report

    International Nuclear Information System (INIS)

    Kim, Sung Hoon; Chun, Kyung Ah; Kim, Young Joo; Park, Seog Hee; Shin, Kyung Sub; Lee, Eun Jung

    1995-01-01

    Percutaneous aspiration needle biopsy of the intrathoracic disease is a safe, easy, and accurate diagnostic method. It usually causes mild pain or discomfort during the procedure. We had a patient who complained of severe sharp pain, well localized at the biopsy site of the target mass during CT-guided transthoracic aspiration biopsy. It was pathologically confirmed as an intrathoracic schwannoma after special staining. To our knowledge, there has been no published report of such a painful percutaneous needle biopsy in a patient with schwannoma in Korea. Two cases were reported in other radiologic journals. The severe sharp pain developed during the transthoracic aspiration needle biopsy is a reliable sign of neurogenic tumor, therefore the participating radiologist should recommend specific immumochemical stain for neurogenic tumor to pathologist

  20. CT-guided spinal injection: initial experience with Sprotte tip needles

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

    2010-09-15

    The purpose of this paper is to describe our initial experience and to illustrate the potential benefits of using small caliber (25 and 27 G), noncutting pencil point needles (Sprotte) with single puncture coaxial technique in CT-guided spinal intervention (CTSI). From January 2009 to June 2009, Sprotte needles with single puncture coaxial technique were used in a total of ten patients for selective nerve root block (SNRB), facet joint block, and pars block under CT fluoroscopy (total of 16 target structures). All procedures were performed without conscious sedation, and visual analog scale (VAS) scores were recorded to determine pain related to needle placement. Total CT fluoroscopy time and out-of-plane needle deviation were obtained. Final needle position was documented by contrast injection for SNRBs and image capture for joint space cannulation. Sixteen out of the 16 structures were successfully targeted. No increase in VAS scores associated with needle placement was recorded, after infiltration of local anesthesia. Optimal peri-neurograms were obtained in all cases of SNRB, despite the side-hole opening in the Sprotte needles. Mean CT fluoroscopy time was 2 s (range 2-8 s per structure), and there was no case of out-of-plane needle deviation that required adjustment of the CT gantry. The use of small caliber Sprotte needles in CTSI is technically feasible and represents a potential refinement to current techniques in the management of chronic spinal pain. (orig.)

  1. Effectiveness of combined use of imprint cytological and histological examination in CT-guided tissue-core biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Yamagami, Takuji; Yoshimatsu, Rika; Kajiwara, Kenji; Ishikawa, Masaki; Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Minami-Ku, Hiroshima (Japan); Matsumoto, Tomohiro; Hasebe, Terumitsu [Tokai University Hachioji Hospital, Tokai University School of Medicine, Department of Radiology, Hachioji, Tokyo (Japan); Kakizawa, Hideaki [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Minami-Ku, Hiroshima (Japan); Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Department of Diagnostic Radiology, Naka-Ku, Hiroshima (Japan); Toyoda, Naoyuki [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Minami-Ku, Hiroshima (Japan); National Hospital Organisation Kure Medical Centre, Department of Diagnostic Radiology, Kure, Hiroshima (Japan)

    2014-05-15

    This study evaluated the efficacy of the combination of imprint cytology and histology in tissue-core percutaneous biopsy under real-time computed tomography (CT) fluoroscopic guidance. Between October 2009 and June 2013, 156 percutaneous needle biopsies were performed in our institution. Those obtained by tissue-core biopsy underwent both imprint cytological and histological examinations routinely after touch imprint cytology was performed on site to evaluate the samples' sufficiency for cytological and pathological examination. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up. Rates of adequate specimens and precise diagnosis, by combined cytological and histological examination were 100 % (156/156) and 96.2 % (150/156), by cytology 94.4 % (152/156) and 83.3 % (130/156) and by histology 99.3 % (155/156) and 92.3 % (144/156). Precise diagnosis was achieved by combined examinations in 94.7 % (89/94) of thoracic lesions, 97.6 % (40/41) of musculoskeletal lesions, and 100 % (21/21) of abdominal, pelvic and retroperitoneal lesions. In all 104 lesions diagnosed as malignant by CT-guided biopsy and in 30 of 52 diagnosed as benign, specific cell types could be proved by combined examinations. Combined imprint cytology and histology performed after on-site touch imprint cytological evaluation improved the diagnostic ability of CT fluoroscopically guided biopsy. (orig.)

  2. Effectiveness of combined use of imprint cytological and histological examination in CT-guided tissue-core biopsy

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Yoshimatsu, Rika; Kajiwara, Kenji; Ishikawa, Masaki; Awai, Kazuo; Matsumoto, Tomohiro; Hasebe, Terumitsu; Kakizawa, Hideaki; Toyoda, Naoyuki

    2014-01-01

    This study evaluated the efficacy of the combination of imprint cytology and histology in tissue-core percutaneous biopsy under real-time computed tomography (CT) fluoroscopic guidance. Between October 2009 and June 2013, 156 percutaneous needle biopsies were performed in our institution. Those obtained by tissue-core biopsy underwent both imprint cytological and histological examinations routinely after touch imprint cytology was performed on site to evaluate the samples' sufficiency for cytological and pathological examination. Final diagnosis was confirmed by independent surgical pathology, independent culture results or clinical follow-up. Rates of adequate specimens and precise diagnosis, by combined cytological and histological examination were 100 % (156/156) and 96.2 % (150/156), by cytology 94.4 % (152/156) and 83.3 % (130/156) and by histology 99.3 % (155/156) and 92.3 % (144/156). Precise diagnosis was achieved by combined examinations in 94.7 % (89/94) of thoracic lesions, 97.6 % (40/41) of musculoskeletal lesions, and 100 % (21/21) of abdominal, pelvic and retroperitoneal lesions. In all 104 lesions diagnosed as malignant by CT-guided biopsy and in 30 of 52 diagnosed as benign, specific cell types could be proved by combined examinations. Combined imprint cytology and histology performed after on-site touch imprint cytological evaluation improved the diagnostic ability of CT fluoroscopically guided biopsy. (orig.)

  3. Comparative study of decomposable and indecomposable biopsy needle in lung puncture biopsy

    International Nuclear Information System (INIS)

    Wang Bo; Sheng Zhanxin; Wen Yamin; Zhang Liping; Wen Zongqiu

    2007-01-01

    Objective: To contrast the clinical practice characteristics with decomposable and indecomposable biopsy needle in the CT-guided lung puncture biopsy. Methods: 50 patients with lung tumour carried on puncture biopsy under the CT guidance were divided in two groups randomly: Group A (25 examples): using the indecomposable BioPinceTM biopsy needle; Group B(25 examples): using the decomposable Precisa or Vitesse biopsy needle. The puncture biopsy organization quantity, the first time puncture success rate, the pathological diagnosis result and the incidence of puncture complication were compared in two groups. Results: More striped structures were gained obviously in group A than in group B: 24/25 and 11/25 respectively (P>0.05), The pathological diagnosis 'serious extrusion amoebocyte and nature undetermined' only occurred in group B. But the first time puncture success rate was lower in group A than in B: 52%(13/25) and 80%(20/25) respectively (P>0.05), The incidence of hemorrhage and pneumothorax in group A was higher slightly: 84% and 72%, 16% and 4% respectively (P>0.05). Conclusion: The indecomposable needle (BioPinceTM) was better in lung puncture biopsy, but the lower first time puncture success rate also increases the risk of operation and complication in some degree because of the structure of the needle. On the contrary, decomposable needle (the Precisa or the Vitesse) was not the best choice in lung puncture biopsy. But it had the original superiority, especially regarding the special patient such as patient with small tumour, thin thoracic wall, bad physique for its nimble operation. It is essential for us to use the two different types of biopsy needle rationally to enhance the level of CT-guided lung puncture biopsy. (authors)

  4. Computed tomography guided needle biopsy: experience from 1,300 procedures

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Isberner, Rony Klaus; Viana, Luciana Marinho; Yu, Liao Shin; Aita, Alessandro Amorim; Soares, Fernando Augusto [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Radiologia e Patologia

    2006-01-15

    Context and objective: computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. Design and setting: retrospective study at Hospital do Cancer A. C. Camargo, Sao Paulo.Methods: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. Results: adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. Conclusion: both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications. (author)

  5. CT-guided puncture

    International Nuclear Information System (INIS)

    Noeldge, G.; Richter, G.M.; Grenacher, L.; Brado, M.; Kauffmann, G.W.

    1996-01-01

    Sonographic and CT-guided punctures allow the evaluation of suspected lesions in the head, thorax, abdomen, retroperitoneum and skeletal system. The size of the lesion to be evaluated determines the size and the diameter of the puncture needle. The quantity of the material obtained will be defined by the diameter of the needle, i.e. fine-needle biopsy is more adequate for cytological than for histological evaluation. Strict adherence to the indications and contraindications for puncture and painstaking performance of the procedure go a long why towards minimizing the complications. The advantage of CT-guided puncture, in contrast to an ultrasound-guided procedure, is visualization during the puncture procedure free from overshadowing. This permits punctures of lesions located deep in the thorax or the abdomen which are overshadowed by the lungs, by air in the small or large bowel or by bone structures. Moreover, this technique yields much more information about the tissues and organs surrounding the suspected lesion. This information is much more investigator-related with ultrasoundguided puncture. Therefore, the CT-guided puncture has become mandatory in the evaluation of suspected lesions. Moreover, using the same technique, percutaneous drainage of fluids in the interpleural space, abscesses in organs, hematomas, lymphoceles and urinomas; ablation of metastases; and sympathicolysis can be carried out. CT-guided puncture thus changes from a minimally invasive diagnostic procedure to a minimally invasive therapy. (orig./MG) [de

  6. Value of CT-guided biopsy in malignant lymphoma; Wertigkeit der CT-gesteuerten Biopsie maligner Lymphome

    Energy Technology Data Exchange (ETDEWEB)

    Libicher, M.; Noeldge, G.; Radeleff, B.; Gholipur, F.; Richter, G.M. [Abteilung Radiodiagnostik, Universitaetsklinikum Heidelberg (Germany)

    2002-12-01

    Management of diagnosing malignant lymphomas has changed with development of CT-guided techniques and reliable biopsy tools.Pathologists can use representative tissue samples for sub classification in more than 90%.Evaluation of residual lymphoma or relapse can be nearly as effective. Therefore percutaneous biopsy can be considered as primary diagnostic tool in the absence of peripheral lymphadenopathy. CT-guided biopsies can be performed on an outpatient basis under conscious sedation considering contraindications as well as regional complications. Acceptance of percutaneous biopsy by the pathologist and oncologist is based on diagnostic effectiveness that is significantly improved if more than 3{dagger}solid tissue samples are taken. This article reviews the value of CT-guided biopsy in comparison to surgical procedures in patients with malignant lymphoma. Essential aspects that lead to a diagnostic percutaneous biopsy are discussed on grounds of the current literature. (orig.) [German] Mit der Entwicklung CT-gesteuerter Biopsieverfahren sowie zuverlaessiger Biopsiesysteme hat sich die Vorgehensweise bei der Diagnostik maligner Lymphome geaendert. Repraesentative Stanzzylinder mit hoher Praeparatequalitaet ermoeglichen dem Pathologen eine Subklassifikation der Lymphome in ueber 90%. Eine aehnlich hohe Treffsicherheit ist auch bei der Rezidivdiagnostik moeglich. Deshalb sind perkutane Biopsien bei fehlender peripherer Lymphadenopathie als primaere diagnostische Methode geeignet. Unter Beachtung der Kontraindikationen sowie der regional unterschiedlichen Komplikationsmoeglichkeiten koennen die meisten CT-gesteuerten Biopsien ambulant unter Analgosedierung durchgefuehrt werden. Die Akzeptanz perkutaner Biopsien durch Pathologen und Onkologen ist an die diagnostische Genauigkeit gekoppelt. Diese wird durch Gewinnung von mindestens 3 repraesentativen Biopsiezylindern aus den soliden Anteilen eines Lymphoms signifikant erhoeht. Die vorliegende Uebersichtsarbeit

  7. Clinical application of multi-detector CT-guided percutaneous coaxial biopsy for pulmonary lesions

    International Nuclear Information System (INIS)

    Jia Ningyang; Liu Shiyuan; Zhang Dianbo; Xiao Xiangsheng; Li Wentao; Li Chenzhou

    2008-01-01

    Objective: To evaluate the clinical application of multi-slice CT-guided percutaneous transthoracic lung coaxial-biopsy for pulmonary lesions. Methods: 152 times of 143 patients were performed with percutaneous transthoracic coaxial biopsy under multiple-slice CT-guidance. Analysis was carried out to investigate the diagnostic accuracy and the relationship between the size of the lesions for coaxial biopsy, together with the complications. Results: The diagnostic accuracy was 94.9% with specificity of 100%, including malignant tumors 116 cases (squamous cell cancer 48 cases, adenocarcinoma 34, small cell undifferentiated carcinoma 6, large cell carcinoma 4, bronchial alveolar carcinoma 8, metastatic carcinoma 16) and 19 cases of benign ones(TB 7 cases, inflammatory pseudotumor 9, hematoma 1, lung abscess 1). The size of lesion had a significant influence on the diagnostic accuracy. Conclusions: Percutaneous transthoracic coaxial lung biopsy is a safety method, possessing a high diagnostic accuracy. (authors)

  8. Percutaneous CT-guided biopsy for lung lesions 1 cm or smaller: the technique, results and complication

    International Nuclear Information System (INIS)

    Song, Chi Sung

    2006-01-01

    The author wanted to assess the diagnostic accuracy and safety of percutaneous biopsy for lung lesions 1 cm or smaller; the biopsies were performed on the basis of the modified coaxial technique under CT guidance. Thirty-five patients (22 men and 13 women) 23-76 years old (average age: 56.8 years) with lung lesions 1 cm or smaller underwent CT-guided percutaneous biopsy. Fifteen patients had underlying primary malignancies. After an 18 G guiding cannula was introduced to the border of the small lung lesion via the modified coaxial technique, fine-needle aspiration biopsy with 21 G needle and core tissue biopsies with 19.5 G or 20 G biopsy guns were performed through the lumen of the guiding cannula. The core tissue biopsies were finished after 6 macroscopic core tissue specimens were obtained. When the needle hit the eccentric portion of the small lung lesion, a 'fanning-out' technique with using the guiding cannula was applied to get multiple core tissue specimens from the small lung lesion. The diagnostic accuracy of this method was evaluated and the complications were reviewed. Both the cytopathologic and histopathologic specimens were obtained in all 35 cases. The fanning-out technique was necessary in 15 cases (43%) for obtaining six core tissue specimens from small lesions. The final diagnoses were 17 malignant lesions and 18 benign lesions. Sixteen lesions were true-positive, eighteen were true-negative, none was false-positive and one was false-negative. The overall diagnostic accuracy was 97%. The sensitivity for detecting malignancy and the specificity for benign lesion were 94% and 100%, respectively. The positive and negative predictive values were 100% and 95%, respectively. The diagnostic ability to characterize the specific cell type of the malignant lesion was 94% (16 of 17), that for the benign lesions was 83% (15 of 18), and overall diagnostic ability was 89% (31 of 35). Five patients (14%) developed a pneumopthorax, and one of them (3%) received

  9. Smartphone-Guided Needle Angle Selection During CT-Guided Procedures.

    Science.gov (United States)

    Xu, Sheng; Krishnasamy, Venkatesh; Levy, Elliot; Li, Ming; Tse, Zion Tsz Ho; Wood, Bradford John

    2018-01-01

    In CT-guided intervention, translation from a planned needle insertion angle to the actual insertion angle is estimated only with the physician's visuospatial abilities. An iPhone app was developed to reduce reliance on operator ability to estimate and reproduce angles. The iPhone app overlays the planned angle on the smartphone's camera display in real-time based on the smartphone's orientation. The needle's angle is selected by visually comparing the actual needle with the guideline in the display. If the smartphone's screen is perpendicular to the planned path, the smartphone shows the Bull's-Eye View mode, in which the angle is selected after the needle's hub overlaps the tip in the camera. In phantom studies, we evaluated the accuracies of the hardware, the Guideline mode, and the Bull's-Eye View mode and showed the app's clinical efficacy. A proof-of-concept clinical case was also performed. The hardware accuracy was 0.37° ± 0.27° (mean ± SD). The mean error and navigation time were 1.0° ± 0.9° and 8.7 ± 2.3 seconds for a senior radiologist with 25 years' experience and 1.5° ± 1.3° and 8.0 ± 1.6 seconds for a junior radiologist with 4 years' experience. The accuracy of the Bull's-Eye View mode was 2.9° ± 1.1°. Combined CT and smart-phone guidance was significantly more accurate than CT-only guidance for the first needle pass (p = 0.046), which led to a smaller final targeting error (mean distance from needle tip to target, 2.5 vs 7.9 mm). Mobile devices can be useful for guiding needle-based interventions. The hardware is low cost and widely available. The method is accurate, effective, and easy to implement.

  10. Percutaneous CT-guided sacroiliac joint sampling for infection: aspiration, biopsy, and technique.

    Science.gov (United States)

    Knipp, David; Simeone, F Joseph; Nelson, Sandra B; Huang, Ambrose J; Chang, Connie Y

    2018-04-01

    To evaluate methods of CT-guided sacroiliac joint sampling in patients with suspected infection. All CT-guided sacroiliac joint sampling procedures for suspected infection were reviewed for sampling type (aspiration, lavage aspiration, biopsy), microbiology results, and clinical and imaging follow-up. The primary gold standard was anatomic pathology. If pathology was not available, then positive blood culture with the same organism as SIJ sampling, imaging and clinical follow-up, or clinical follow-up only were used. Anterior and posterior joint distention was evaluated by MRI within 7 days of the procedure. A total of 34 patients (age 39 ± 20 (range, 6-75) years; 21 F, 13 M) were included. Aspiration samples only were obtained in 13/34 (38%) cases, biopsy samples only in 9/34 (26%) cases, and both samples in 12/34 (35%) cases. There was an overall 54% sensitivity and 86% specificity. For the aspiration samples, sensitivity and specificity were 60 and 81%, respectively, compared to 45 and 90% for the biopsy samples. In cases with both samples, biopsy did not add additional microbial information. Seventeen (17/34, 50%) patients had an MRI. The anterior joint was more distended than the posterior joint in 15/17 (88%) of patients, and this difference was significant (P = 0.0003). All of these 17 patients had an attempted aspiration by a posterior approach; 6/17 (35%) resulted in a successful aspiration. Aspiration of the sacroiliac joint has a higher sensitivity than biopsy and should always be attempted first. MRI may be helpful for procedure planning.

  11. Percutaneous CT-guided sacroiliac joint sampling for infection. Aspiration, biopsy, and technique

    Energy Technology Data Exchange (ETDEWEB)

    Knipp, David; Simeone, F.J.; Huang, Ambrose J.; Chang, Connie Y. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Nelson, Sandra B. [Massachusetts General Hospital, Infectious Disease Unit, Department of Medicine, Boston, MA (United States)

    2018-04-15

    To evaluate methods of CT-guided sacroiliac joint sampling in patients with suspected infection. All CT-guided sacroiliac joint sampling procedures for suspected infection were reviewed for sampling type (aspiration, lavage aspiration, biopsy), microbiology results, and clinical and imaging follow-up. The primary gold standard was anatomic pathology. If pathology was not available, then positive blood culture with the same organism as SIJ sampling, imaging and clinical follow-up, or clinical follow-up only were used. Anterior and posterior joint distention was evaluated by MRI within 7 days of the procedure. A total of 34 patients (age 39 ± 20 (range, 6-75) years; 21 F, 13 M) were included. Aspiration samples only were obtained in 13/34 (38%) cases, biopsy samples only in 9/34 (26%) cases, and both samples in 12/34 (35%) cases. There was an overall 54% sensitivity and 86% specificity. For the aspiration samples, sensitivity and specificity were 60 and 81%, respectively, compared to 45 and 90% for the biopsy samples. In cases with both samples, biopsy did not add additional microbial information. Seventeen (17/34, 50%) patients had an MRI. The anterior joint was more distended than the posterior joint in 15/17 (88%) of patients, and this difference was significant (P = 0.0003). All of these 17 patients had an attempted aspiration by a posterior approach; 6/17 (35%) resulted in a successful aspiration. Aspiration of the sacroiliac joint has a higher sensitivity than biopsy and should always be attempted first. MRI may be helpful for procedure planning. (orig.)

  12. Pleural needle biopsy

    Science.gov (United States)

    ... own. Sometimes, a chest tube is needed to drain the air and expand the lung. There is also a chance of excessive blood loss. Considerations If a closed pleural biopsy is not enough to make a diagnosis, ...

  13. Efficacy of an opposite position aspiration on resolution of pneumothorax following CT-guided lung biopsy

    Science.gov (United States)

    Zeng, L-C; Du, Y; Yang, H-F; Xie, M-G; Liao, H-Q; Zhang, Y-D; Li, L; Wang, Q; Hu, L

    2015-01-01

    Objective: To evaluate the efficacy of aspiration in an opposite position to deal with pneumothorax after CT-guided lung biopsy. Methods: A retrospective study was developed involving 210 patients with pneumothorax who had undergone CT-guided percutaneous core biopsies from January 2012 to March 2014 for various pulmonary lesions. Asymptomatic patients with minimal pneumothorax were treated conservatively. Simple manual aspiration was performed for symptomatic patients with minimal pneumothorax and for all patients with moderate to large pneumothorax. An opposite position aspiration was performed when simple manual aspiration failed. The efficacy of simple manual aspiration and the opposite position aspiration was observed. Results: Among 210 patients with pneumothorax, 128 (61.0%) asymptomatic patients with minimal pneumothorax were treated conservatively. The remaining 82 were treated with attempted simple manual aspiration. Out of these 82 patients, simple manual aspiration was successful in 58 (70.7%, 58/82) cases. The complete and partial regression rates were 17.2% (10/58) and 82.8% (48/58), respectively. In the other 24 patients (29.3%, 24/82), simple aspiration technique was ineffective. An opposite position (from prone to supine or vice versa) was applied, and a new biopsy puncture site was chosen for reaspiration. This procedure was successful in 22 patients but not in 2 patients who had to have a chest tube insertion. The complete and partial regression rates were 25.0% (6/24) and 66.7% (16/24), respectively. Applying the new method, the total effective rate of aspiration improved significantly from 70.7% (58/82) to 97.6% (80/82). Conclusion: The opposite position aspiration can be safe, effective and minimally invasive treatment for CT-guided lung biopsy-induced pneumothorax thus reducing the use of chest tube significantly. Advances in knowledge: (1) Opposite position aspiration can elevate the success rate of aspiration significantly (from 70.7% to 97

  14. Radiation exposure during CT-guided biopsies: recent CT machines provide markedly lower doses.

    Science.gov (United States)

    Guberina, Nika; Forsting, Michael; Ringelstein, Adrian; Suntharalingam, Saravanabavaan; Nassenstein, Kai; Theysohn, Jens; Wetter, Axel

    2018-03-28

    To examine radiation dose levels of CT-guided interventional procedures of chest, abdomen, spine and extremities on different CT-scanner generations at a large multicentre institute. 1,219 CT-guided interventional biopsies of different organ regions ((A) abdomen (n=516), (B) chest (n=528), (C) spine (n=134) and (D) extremities (n=41)) on different CT-scanners ((I) SOMATOM-Definition-AS+, (II) Volume-Zoom, (III) Emotion6) were included from 2013-2016. Important CT-parameters and standard dose-descriptors were retrospectively examined. Additionally, effective dose and organ doses were calculated using Monte-Carlo simulation, following ICRP103. Overall, radiation doses for CT interventions are highly dependent on CT-scanner generation: the newer the CT scanner, the lower the radiation dose imparted to patients. Mean effective doses for each of four procedures on available scanners are: (A) (I) 9.3mSv versus (II) 13.9mSv (B) (I) 7.3mSv versus (III) 11.4mSv (C) (I) 6.3mSv versus (II) 7.4mSv (D) (I) 4.3mSv versus (II) 10.8mSv. Standard dose descriptors [standard deviation (SD); CT dose index vol (CTDI vol ); dose-length product (DLP body ); size-specific dose estimate (SSDE)] were also compared. Effective dose, organ doses and SSDE for various CT-guided interventional biopsies on different CT-scanner generations following recommendations of the ICRP103 are provided. New CT-scanner generations involve markedly lower radiation doses versus older devices. • Effective dose, organ dose and SSDE are provided for CT-guided interventional examinations. • These data allow identifying organs at risk of higher radiation dose. • Detailed knowledge of radiation dose may contribute to a better individual risk-stratification. • New CT-scanner generations involve markedly lower radiation doses compared to older devices.

  15. CT-guided biopsies and drainage; CT-gesteuerte Punktionen und Drainagen

    Energy Technology Data Exchange (ETDEWEB)

    Scheppers, I.; Wollschlaeger, D. [Staedtisches Klinikum Karlsruhe gGmbH, Zentralinstitut fuer Bildgebende Diagnostik, Karlsruhe (Germany)

    2011-11-15

    Following the implementation of computed tomography (CT) or ultrasound-guided biopsy of solid tumors and the puncture and drainage of liquid processes, the number of surgical open biopsies and curative operations for abscess drainage has declined. Such CT-guided interventions are performed in nearly every organ. Instead of aspiration biopsies, more and more core biopsies are being performed to allow histopathological evaluation and thus allowing targeted therapy. This article is intended to give a general overview of techniques, materials, indications and contraindications. Ultrasound-guided biopsies as well as large bore vacuum biopsies of the breast are not included in this review. (orig.) [German] Infolge der Durchfuehrung von bildgesteuerten Biopsien solider Raumforderungen und Punktionen mit Drainageeinlage bei liquiden Prozessen ist die Zahl chirurgischer Exzisionsbiopsien und Abszesssanierungen zurueckgegangen. Diese Eingriffe werden in nahezu allen Organgebieten durchgefuehrt. Neben den Aspirationsbiopsien werden haeufig Schneid- oder Stanzbiopsien durchgefuehrt. Nach histologischer und immunhistologischer Untersuchung der hierbei gewonnenen Proben in der Pathologie kann fruehzeitig die nachfolgende Therapie geplant werden. Der vorliegende Beitrag soll einen allgemeinen Ueberblick ueber Methoden, Materialien, Indikationen und Kontraindikationen geben. Die ultraschallgesteuerten Biopsien sowie die Vakuumsaugbiopsien im Rahmen des Mammographiescreenings werden bewusst nicht besprochen. (orig.)

  16. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A., E-mail: nour410@hotmail.com [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Cairo University Hospital, Cairo (Egypt); Alsubhi, Mohammed [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Naguib, Nagy N. [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Alexandria University Hospital, Alexandria (Egypt); Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany)

    2014-10-15

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  17. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    International Nuclear Information System (INIS)

    Nour-Eldin, Nour-Eldin A.; Alsubhi, Mohammed; Naguib, Nagy N.; Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar

    2014-01-01

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  18. Transthoracic needle biopsy: factors effecting risk of pneumothorax

    International Nuclear Information System (INIS)

    Topal, Ugur; Ediz, Buelent

    2003-01-01

    Objective: to evaluate the factors that could effect the risk of pneumothorax in patients undergoing transthoracic biopsy. Material and methods: variables that could increase the risk of pneumothorax were evaluated in 453 CT-guided transthoracic biopsies. Factors were evaluated in two groups: (1) lesion related (presence of emphysema around the lesion, lesion depth, cavitation, presence of fissure/atelectasis and pleural tag in the needle trajectory); and (2) procedure related (biopsy type, needle size, number of passages, level of experience of the operator). All variables were analysed by χ 2 test and multivariate logistic regression statistics. Results: pneumothorax was developed in 85 (18.8%) out of 453 procedures. A chest tube was inserted in ten (11.7%) of them. Variables that were significantly associated with an increased risk of pneumothorax were depth of the lesion (P<0.001) and severity of the emphysema (P<0.01). Conclusion: the length of the lung parenchyma traversed during the biopsy is the predominant risk factor for pneumothorax in patients undergoing CT-guided transthoracic biopsy. The risk of pneumothorax was also increased with the severity of the emphysema around the lesion

  19. Lung needle biopsy

    Science.gov (United States)

    ... if you have certain lung diseases such as emphysema. Usually, a collapsed lung after a biopsy does not need treatment. But ... any type Bullae (enlarged alveoli that occur with emphysema) Cor pulmonale (condition ... of the lung High blood pressure in the lung arteries Severe ...

  20. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  1. CT-Guided Transgluteal Biopsy for Systematic Random Sampling of the Prostate in Patients Without Rectal Access.

    Science.gov (United States)

    Goenka, Ajit H; Remer, Erick M; Veniero, Joseph C; Thupili, Chakradhar R; Klein, Eric A

    2015-09-01

    The objective of our study was to review our experience with CT-guided transgluteal prostate biopsy in patients without rectal access. Twenty-one CT-guided transgluteal prostate biopsy procedures were performed in 16 men (mean age, 68 years; age range, 60-78 years) who were under conscious sedation. The mean prostate-specific antigen (PSA) value was 11.4 ng/mL (range, 2.3-39.4 ng/mL). Six had seven prior unsuccessful transperineal or transurethral biopsies. Biopsy results, complications, sedation time, and radiation dose were recorded. The mean PSA values and number of core specimens were compared between patients with malignant results and patients with nonmalignant results using the Student t test. The average procedural sedation time was 50.6 minutes (range, 15-90 minutes) (n = 20), and the mean effective radiation dose was 8.2 mSv (median, 6.6 mSv; range 3.6-19.3 mSv) (n = 13). Twenty of the 21 (95%) procedures were technically successful. The only complication was a single episode of gross hematuria and penile pain in one patient, which resolved spontaneously. Of 20 successful biopsies, 8 (40%) yielded adenocarcinoma (Gleason score: mean, 8; range, 7-9). Twelve biopsies yielded nonmalignant results (60%): high-grade prostatic intraepithelial neoplasia (n = 3) or benign prostatic tissue with or without inflammation (n = 9). Three patients had carcinoma diagnosed on subsequent biopsies (second biopsy, n = 2 patients; third biopsy, n = 1 patient). A malignant biopsy result was not significantly associated with the number of core specimens (p = 0.3) or the mean PSA value (p = 0.1). CT-guided transgluteal prostate biopsy is a safe and reliable technique for the systematic random sampling of the prostate in patients without a rectal access. In patients with initial negative biopsy results, repeat biopsy should be considered if there is a persistent rise in the PSA value.

  2. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

    Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann

    2011-01-01

    To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking.......To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

  3. Improving CT-guided transthoracic biopsy of mediastinal lesions by diffusion-weighted magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; TyngI, Chiang Cheng; Bitencourt, Almir Galvao Vieira; Gross, Jefferson Luiz; Zurstrassen, Charles Edouard, E-mail: marcosduarte500@gmail.com [AC Camargo Cancer Center, Sao Paulo, SP (Brazil); Hochhegger, Bruno [Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA), RS (Brazil). Dept. de Radiologia; Benveniste, Marcelo Felipe Kuperman; Odisio, Bruno Calazans [University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Marchiori, Edson [Universidade Federal do Rio de Janeiro (UFRJ), Petropolis, RJ (Brazil)

    2014-11-15

    Objectives: to evaluate the preliminary results obtained using diffusion-weighted magnetic resonance imaging and the apparent diffusion coefficient for planning computed tomography-guided biopsies of selected mediastinal lesions. Methods: eight patients with mediastinal lesions suspicious for malignancy were referred for computed tomography-guided biopsy. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient measurement were performed to assist in biopsy planning with diffusion/computed tomography fused images. We selected mediastinal lesions that could provide discordant diagnoses depending on the biopsy site, including large heterogeneous masses, lesions associated with lung atelectasis or consolidation, lesions involving large mediastinal vessels and lesions for which the results of biopsy using other methods and histopathological examination were divergent from the clinical and radiological suspicion. Results: in all cases, the biopsy needle was successfully directed to areas of higher signal intensity on diffusion weighted sequences and the lowest apparent diffusion coefficient within the lesion (mean, 0.8 [range, 0.6–1.1]610{sup -3} mm{sup 2}/s), suggesting high cellularity. All biopsies provided adequate material for specific histopathological diagnoses of four lymphomas, two sarcomas and two thymoma s. Conclusion: functional imaging tools, such as diffusion-weighted imaging and the apparent diffusion coefficient, are promising for implementation in noninvasive and imaging-guided procedures. However, additional studies are needed to confirm that mediastinal biopsy can be improved with these techniques. (author)

  4. Efficacy of CT-guided biopsies of the spine in patients with spondylitis – an analysis of 164 procedures

    International Nuclear Information System (INIS)

    Heyer, Christoph M.; Brus, Lisa-Johanna; Peters, Soeren A.; Lemburg, Stefan P.

    2012-01-01

    Objective: To evaluate efficacy of CT-guided spinal biopsy (CTSB) in patients with spondylitis considering patient characteristics, technical issues, antibiotic therapy, histopathological, and microbiological findings. Materials and methods: All CTSB procedures performed between 1995 and 2009 in patients with proven spondylitis were re-evaluated. Patient sex and age, antibiotic treatment, biopsy approach, number of specimens, length of needle path, laboratory results (CRP, WBC), and histopathological/microbiological findings were documented and compared to the final diagnosis of spondylitis. Statistical analysis was performed using Chi-square test and Student's t-test. The p-value was set to 5%. Results: 164 CTSB procedures were performed in 159 patients (mean age 65 years, 60% men) in which spondylitis was histopathologically verified in 95%. Neither patient sex nor age, positioning, localization of the spinal lesion, bioptic approach, number of specimens, or depth of the needle showed significant impact on the rate of positive histopathological findings. A causative germ was identified in 40/127 biopsies (32%) with Staphylococcus aureus being identified in 50%. Tuberculous spondylitis was diagnosed in ten cases (6%). CRP significantly correlated with bacterial growth (13.3 ± 12.2 mg/dl versus 8.8 ± 7.6 mg/dl; p = .015) whereas administration of antibiotics did not show any significant impact on bacterial growth (29% versus 36% in patients without antibiotics; p = 0.428). Patients with histopathological signs of active spondylitis showed a significantly higher CRP (16.5 ± 15.8 mg/dl versus 8.9 ± 8.0 mg/dl, p < .001). Complication rate was 0.6% (one focal bleeding). Conclusion: CTSB of the spine in suspected spondylitis is an effective and safe procedure for establishing final histopathological diagnosis. However, microbiological yield is low regardless of technical issues and antibiotic therapy. Other than CRP values, laboratory investigations added little

  5. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

    Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann

    2011-01-01

    To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

  6. Bone biopsy needles. Mechanical properties, needle design and specimen quality

    International Nuclear Information System (INIS)

    Keulers, Annika; Penzkofer, T.; Cunha-Cruz, V.C.; Bruners, P.; Helmholtz Inst. fuer biomedizinische Technik, Aachen; Braunschweig, T.; Schmitz-Rode, T.; Mahnken, A.; Helmholtz Inst. fuer biomedizinische Technik, Aachen

    2011-01-01

    To quantitatively analyze differences in mechanical properties, needle design including signs of wear, subjective handling and specimen quality of bone biopsy needles. Materials and Methods: In this study 19 different bone biopsy systems (total 38; 2 /type) were examined. With each biopsy needle five consecutive samples were obtained from vertebral bodies of swine. During puncture a force-torques sensor measured the mechanical properties and subjective handling was assessed. Before and after each biopsy the needles were investigated using a profile projector and signs of wear were recorded. Afterwards, a pathologist semi-quantitatively examined the specimen regarding sample quality. The overall evaluation considered mechanical properties, needle wear, subjective handling and sample quality. Differences were assessed for statistical significance using ANOVA and t-test. Results: Needle diameter (p = 0.003) as well as needle design (p = 0.008) affect the mechanical properties significantly. Franseen design is significantly superior to other needle designs. Besides, length reduction recorded by the profile projector, as a quality criterion showed notable distinctions in between the needle designs. Conclusion: Bone biopsy needles vary significantly in performance. Needle design has an important influence on mechanical properties, handling and specimen quality. Detailed knowledge of those parameters would improve selecting the appropriate bone biopsy needle. (orig.)

  7. MDCT-Guided Transthoracic Needle Aspiration Biopsy of the Lung Using the Transscapular Approach

    International Nuclear Information System (INIS)

    Rossi, Umberto G.; Seitun, Sara; Ferro, Carlo

    2011-01-01

    The purpose of this study is to report our preliminary experience using MDCT-guided percutaneous transthoracic needle aspiration biopsy using the transscapular approach in the upper posterolateral lung nodules, an area that it is difficult or hazardous to reach with the conventional approach. Five patients underwent CT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach. A coaxial needle technique was used in all patients. Biopsy was successful in all patients. No major complications were encountered. One patient developed a minimal pneumothorax next to the lesion immediately after biopsy, which resolved spontaneously. MDCT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach is an effective and safe procedure that reduces the risk of pneumothorax in selected patients.

  8. CT-Guided Biopsy in Suspected Spondylodiscitis--The Association of Paravertebral Inflammation with Microbial Pathogen Detection.

    Directory of Open Access Journals (Sweden)

    Daniel Spira

    Full Text Available To search for imaging characteristics distinguishing patients with successful from those with futile microbiological pathogen detection by CT-guided biopsy in suspected spondylodiscitis.34 consecutive patients with suspected spondylodiscitis underwent CT-guided biopsy for pathogen detection. MR-images were assessed for inflammatory infiltration of disks, adjacent vertebrae, epidural and paravertebral space. CT-images were reviewed for arrosion of adjacent end plates and reduced disk height. Biopsy samples were sent for microbiological examination in 34/34 patients, and for additional histological analysis in 28/34 patients.Paravertebral infiltration was present in all 10/10 patients with positive microbiology and occurred in only 12/24 patients with negative microbiology, resulting in a sensitivity of 100% and a specificity of 50% for pathogen detection. Despite its limited sensitivities, epidural infiltration and paravertebral abscesses showed considerably higher specificities of 83.3% and 90.9%, respectively. Paravertebral infiltration was more extensive in patients with positive as compared to negative microbiology (p = 0.002. Even though sensitivities for pathogen detection were also high in case of vertebral and disk infiltration, or end plate arrosion, specificities remained below 10%.Inflammatory infiltration of the paravertebral space indicated successful pathogen detection by CT-guided biopsy. Specificity was increased by the additional occurrence of epidural infiltration or paravertebral abscesses.

  9. Evaluation of chronic infectious interstitial pulmonary disease in children by low-dose CT-guided transthoracic lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Heyer, Christoph M.; Lemburg, Stefan P.; Kagel, Thomas; Nicolas, Volkmar [Ruhr-University of Bochum, Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, BG Clinics Bergmannsheil, Bochum (Germany); Mueller, Klaus-Michael [Ruhr-University of Bochum, Institute of Pathology, BG Clinics Bergmannsheil, Bochum (Germany); Nuesslein, Thomas G.; Rieger, Christian H.L. [Ruhr-University of Bochum, Pediatric Hospital, Bochum (Germany)

    2005-07-01

    Children with chronic infectious interstitial lung disease often have to undergo open lung biopsy to establish a final diagnosis. Open lung biopsy is an invasive procedure with major potential complications. Transthoracic lung biopsy (TLB) guided by computed tomography (CT) is a less-invasive well-established procedure in adults. Detailing the role of low-dose CT-guided TLB in the enhanced diagnosis of chronic lung diseases related to infection in children. A group of 11 children (age 8 months to 16 years) underwent CT-guided TLB with a 20-gauge biopsy device. All investigations were done under general anaesthesia on a multidetector CT scanner (SOMATOM Volume Zoom, Siemens, Erlangen, Germany) using a low-dose protocol (single slices, 120 kV, 20 mAs). Specimens were processed by histopathological, bacteriological, and virological techniques. All biopsies were performed without major complications; one child developed a small pneumothorax that resolved spontaneously. A diagnosis could be obtained in 10 of the 11 patients. Biopsy specimens revealed chronic interstitial alveolitis in ten patients. In five patients Chlamydia pneumoniae PCR was positive, in three Mycoplasma pneumoniae PCR was positive, and in two Cytomegalovirus PCR was positive. The average effective dose was 0.83 mSv. Low-dose CT-guided TLB can be a helpful tool in investigating chronic infectious inflammatory processes in children with minimal radiation exposure. It should be considered prior to any open surgical procedure performed for biopsy alone. In our patient group no significant complication occurred. A disadvantage of the method is that it does not allow smaller airways and vessels to be assessed. (orig.)

  10. CT-guided percutaneous injection of the fibrin glue by 'double needle' technique for the treatment of sacral cysts

    International Nuclear Information System (INIS)

    Wang Ganggang; Chen Long; Yang Chao; Ni Caifang

    2013-01-01

    Objective: To analyze the efficacy and safety of CT-guided percutaneous injection of the fibrin glue by 'double needle' technique to treat sacral cyst. Methods: Clinical data of 20 cases with 'double-needle' injection of fibrin glue technology to treat sacral cyst were retrospectively analyzed. All patients had varying degrees of sacral nerve root compression symptoms. The treatment for sacral cyst was carried out after clear diagnosis was made. On the basis of CT-guided percutaneous injection of fibrin glue, the improved CT-guided percutaneous injection of fibrin glue by 'double-needle' technique was used to treat these patients. The average dose of fibrin glue was (5.9 ± 2.4) ml. The clinical results of improvement as to pain and neurological function were evaluated after follow-up of an average of 17 months. The assessment criteria were as follows: excellent, complete resolution of signs and symptoms, with the patient returning to his or her regular employment and no recurrence of cysts during 1 year of follow-up, good, symptoms and signs in the legs and perineal region resolved but with persistent pain in the lumbosacral region, which did not interfere with the patient's regular work (the cysts did not recur for 6 months during follow-up), fair, no improvement in clinical symptoms, but a decrease in cyst size on the imaging study, poor, no improvement in clinical symptoms and no observed changes in cyst size in imaging studies or recurrence. Results: Most patients experienced some degree of pain relief and functional improvement after fibrin glue therapy, with most experiencing complete or marked resolution of clinical symptoms. Nine patients reported excellent recovery, 8 reported good recovery, 2 reported fair recovery, and 1 reported poor recovery. The overall percentage of positive outcomes (excellent and good recovery) was 85%. No serious postoperative complications were discovered. Conclusions: CT guided percutaneous injection of the fibrin glue by

  11. BEM-based simulation of lung respiratory deformation for CT-guided biopsy.

    Science.gov (United States)

    Chen, Dong; Chen, Weisheng; Huang, Lipeng; Feng, Xuegang; Peters, Terry; Gu, Lixu

    2017-09-01

    Accurate and real-time prediction of the lung and lung tumor deformation during respiration are important considerations when performing a peripheral biopsy procedure. However, most existing work focused on offline whole lung simulation using 4D image data, which is not applicable in real-time image-guided biopsy with limited image resources. In this paper, we propose a patient-specific biomechanical model based on the boundary element method (BEM) computed from CT images to estimate the respiration motion of local target lesion region, vessel tree and lung surface for the real-time biopsy guidance. This approach applies pre-computation of various BEM parameters to facilitate the requirement for real-time lung motion simulation. The resulting boundary condition at end inspiratory phase is obtained using a nonparametric discrete registration with convex optimization, and the simulation of the internal tissue is achieved by applying a tetrahedron-based interpolation method depend on expert-determined feature points on the vessel tree model. A reference needle is tracked to update the simulated lung motion during biopsy guidance. We evaluate the model by applying it for respiratory motion estimations of ten patients. The average symmetric surface distance (ASSD) and the mean target registration error (TRE) are employed to evaluate the proposed model. Results reveal that it is possible to predict the lung motion with ASSD of [Formula: see text] mm and a mean TRE of [Formula: see text] mm at largest over the entire respiratory cycle. In the CT-/electromagnetic-guided biopsy experiment, the whole process was assisted by our BEM model and final puncture errors in two studies were 3.1 and 2.0 mm, respectively. The experiment results reveal that both the accuracy of simulation and real-time performance meet the demands of clinical biopsy guidance.

  12. Fatal paradoxical pulmonary air embolism complicating percutaneous computed tomography-guided needle biopsy of the lung

    International Nuclear Information System (INIS)

    Chakravarti, Rajesh; Singh, Virendra; Isaac, Rethish; John, Joseph

    2004-01-01

    A 63-year-old man with left upper zone haziness on chest X-ray and an infiltrative lesion with a pleural mass in the left upper lobe on CT scan was scheduled for CT-guided percutaneous trans-thoracic needle biopsy. During the procedure, the patient had massive haemoptysis and cardiorespiratory arrest and could not be revived. Post-mortem CT showed air in the right atrium, right ventricle, pulmonary artery and also in the left atrium and aorta. A discussion on paradoxical air embolism following percutaneous trans-thoracic needle biopsy is presented Copyright (2004) Blackwell Publishing Asia Pty Ltd

  13. Needle muscle biopsy and its application

    Directory of Open Access Journals (Sweden)

    Meng-long CHEN

    2015-07-01

    Full Text Available Needle muscle biopsy is a straightforward and reliable minimally-invasive technique. During the past century, the needle biopsy can provide adequate samples and the technique has gradually gained wider acceptance. Compared with open biopsy, needle biopsy is less traumatic, with low rate of complications, and is suitable for the identifications and evaluations of muscular dystrophy, inflammatory myopathies and systemic diseases involving muscles, specially for infants and young children. Domestic insiders should be encouraged to apply this technique. DOI: 10.3969/j.issn.1672-6731.2015.06.003 

  14. CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

    International Nuclear Information System (INIS)

    Fukuda, Hozumi; Ibukuro, Kenji; Tsukiyama, Toshitaka; Ishii, Rei

    2004-01-01

    We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which were therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis

  15. CT guided biopsies as a part of the investigations in findings in the lung and thorax wall

    DEFF Research Database (Denmark)

    Vagn-Hansen, Chris Aksel; Pedersen, Malene Roland Vils; Rafaelsen, Søren Rafael

    was performed. Results: In 86 % of the biopsies, the tissue material was found sufficient. In 32 % of the biopsies there was a complication, mostly pneumothorax (30%), but in only 15 % of the 520 cases chest drainage was needed. There was one death in a known cancer patient with severe reduced lung and cardiac...... function. Patients with more than 10 cigarette pack years had a complication risk twice as high compared to patients with less pack years. We found that the risk of pneumothorax rises the further the lesion is from the skin surface, the smaller the lesions are and when the patient is biopsied in a lateral...... position. We found a higher risk of complications in females. Conclusion: CT guided biopsy is an excellent tool in the analysis of lesions in the lungs. This study clearly shows that the risk of developing a pneumothorax is significantly higher among smokers and former smokers with more than 10 pack years....

  16. Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study

    International Nuclear Information System (INIS)

    Ghaye, B.; Dondelinger, R.F.; Dewe, W.

    1999-01-01

    The aim of this study was to evaluate in a prospective and randomized study spiral versus sequential scanning in the guidance of percutaneous lung biopsy. Fifty thoracic lesions occurring in 48 patients were biopsied by a senior and a junior operator. Six different time segments of the procedure were measured. Scanning mode versus length of procedure, pathological results, irradiation and complications were evaluated. Total duration of the procedure and of the first sampling was significantly longer with spiral CT for the senior operator (p < 0.004). No significant time difference was observed for the junior operator. Diameter of the lesion, depth of location, position of the patient and needle entry site did not influence the results. The sensitivity was 90.9, specificity 100, positive predictive value 100 and negative predictive value 60 % for spiral CT, and 94.7, 100, 100 and 85.7 % for sequential CT, respectively. Eleven pneumothoraces and ten perinodular hemorrhages were seen with spiral CT and six and ten, respectively, with sequential CT. The mean dose of irradiation was 4027 mAs for spiral CT and 2358 mAs for conventional CT. Spiral CT does neither reduce procedure time nor the rate of complications. Pathological results do not differ compared with sequential CT, and total dose of irradiation is higher with spiral scanning. (orig.)

  17. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Rosenthal, Daniel I. [Massachusetts General Hospital, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute of Technology Assessment, Boston, MA (United States)

    2013-01-15

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  18. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

    International Nuclear Information System (INIS)

    Huang, Ambrose J.; Rosenthal, Daniel I.; Halpern, Elkan F.

    2013-01-01

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  19. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients.

    Science.gov (United States)

    Nour-Eldin, Nour-Eldin A; Alsubhi, Mohammed; Emam, Ahmed; Lehnert, Thomas; Beeres, Martin; Jacobi, Volkmar; Gruber-Rouh, Tatjana; Scholtz, Jan-Erik; Vogl, Thomas J; Naguib, Nagy N

    2016-02-01

    patients: 13.7 %), from which one patient developed a persistent air leakage necessitating pleurodesis. Pneumothorax complicating CT-guided core biopsy of pulmonary lesions, showed the insignificant difference between coaxial and non-coaxial techniques. However, both techniques have the same significant risk factors including small and basal lesions, increased lesion's depth from pleural surface, and increased length of aerated lung parenchyma crossed by biopsy needle and passing through pulmonary fissures in the needle tract.

  20. Needle Biopsy of the Lung

    Science.gov (United States)

    ... clip. The needle is hollow so it can capture the tissue specimen. There are several types of ... breath, difficulty in catching your breath, rapid pulse (heart rate), sharp chest or shoulder pain with breathing, ...

  1. Pulmonary emphysema is a predictor of pneumothorax after CT-guided transthoracic pulmonary biopsies of pulmonary nodules.

    Science.gov (United States)

    Lendeckel, Derik; Kromrey, Marie-Luise; Ittermann, Till; Schäfer, Sophia; Mensel, Birger; Kühn, Jens-Peter

    2017-01-01

    Pneumothoraces are the most frequently occurring complications of CT-guided percutaneous transthoracic pulmonary biopsies (PTPB). The aim of this study was to evaluate the influence of pre-diagnostic lung emphysema on the incidence and extent of pneumothoraces and to establish a risk stratification for the evaluation of the pre-procedure complication probability. CT-guided PTPB of 100 pre-selected patients (mean age 67.1±12.8 years) were retrospectively enrolled from a single center database of 235 PTPB performed between 2012-2014. Patients were grouped according to pneumothorax appearance directly after PTPB (group I: without pneumothorax, n = 50; group II: with pneumothorax, n = 50). Group II was further divided according to post-interventional treatment (group IIa: chest tube placement, n = 24; group IIb: conservative therapy, n = 26). For each patient pre-diagnostic percentage of emphysema was quantified using CT density analysis. Emphysema stages were compared between groups using bivariate analyses and multinomial logistic regression analyses. Emphysema percentage was significantly associated with the occurrence of post-interventional pneumothorax (p = 0.006). Adjusted for potential confounders (age, gender, lesion size and length of interventional pathway) the study yielded an OR of 1.07 (p = 0.042). Absolute risk of pneumothorax increased from 43.4% at an emphysema rate of 5% to 73.8% at 25%. No differences could be seen in patients with pneumothorax between percentage of emphysema and mode of therapy (p = 0.721). The rate of lung emphysema is proportionally related to the incidence of pneumothorax after CT-guided PTPB and allows pre-interventional risk stratification. There is no association between stage of emphysema and post-interventional requirement of chest tube placement.

  2. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ... Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During ...

  3. Analysis of a Steerable Needle for Fine Needle Aspiration and Biopsy: Efficiency and Radiation Dose Compared With a Conventional Straight Needle.

    Science.gov (United States)

    Rutigliano, Sandra; Abraham, John A; Kenneally, Barry E; Zoga, Adam C; Nevalainen, Mika; Roedl, Johannes B

    Percutaneous computed tomography (CT)-guided needle biopsy has proven to be an efficacious method for sampling of many soft tissue lesions, especially deep-seated masses in the abdomen and pelvis. This study sought to test the potential for a novel steerable needle to improve localization and to reduce procedure duration and radiation dose compared with a conventional straight needle. A fresh, raw meat sample (lean bovine flank) was imbedded with cylindrical radiopaque and radiolucent obstacles designed to simulate vessels (radiolucent objects) and bones (radiopaque objects) on CT. A pit-containing olive (partially radiopaque) was imbedded beyond the obstacles to represent the target. Two sites on the surface of the meat were selected and marked to determine initial needle placement. Two radiologists with different levels of experience proceeded to position a straight needle and the steerable needle from each skin site to the target using CT guidance as efficiently as possible, avoiding the obstacles. The total positioning time, the number of CT scans required for positioning, and the number of repositioning events (partial withdrawal followed by advancement) were tracked for the straight and steerable needles. For the straight needle, total time to reach the target was 499 to 667 seconds (mean, 592 seconds); for the steerable needle, total time to reach the target was 281 to 343 seconds (mean, 309 seconds), on average, 48% lower. The number of CT scans needed for needle positioning averaged 6.25 for the straight needle and 3.5 for the steerable needle, which is 44% lower. Repositioning events (withdrawing and readvancing the needle) ranged from 3 to 10 for the straight needle (mean, 6.5) and 0 for the steerable needle. Using an in vitro model embedded with obstacles, the steerable needle performed better than a straight needle with regard to procedure time, needle repositioning events, and CT scans required for placement.

  4. Computed tomography-guided needle biopsy of lung lesions in fourteen cats and dogs

    International Nuclear Information System (INIS)

    Yoshida, K.; Mori, T.; Yamada, M.; Sakaida, M.; Yonemaru, K.; Murakami, M.; Sakai, H.; Maruo, K.

    2007-01-01

    Computed tomography (CT)-guided fine-needle aspirates (FNA) or core biopsies of lung lesions were performed in nine dogs and five cats. A clinical diagnosis was obtained in twelve of fourteen animals (85%), namely 80% FNA and 100% core biopsies. Eight animals had other mass (es) apart from the lung, and five were diagnosed to metastases. In only one case, the lung mass was histopathologically diagnosed as a malignant primary tumor. Iatrogenic complications through the lung biopsies were noted in four animals, and three showed mild pneumothorax on CT images and one was bleeding from the needle. However, between fifteen and thirty minutes after the biopsy, no animal indicated signs of pneumothorax or hemorrhage

  5. CT-guided core biopsy and percutaneous fiducial seed placement in the lung: Can these procedures be combined without an increase in complication rate or decrease in technical success?

    Energy Technology Data Exchange (ETDEWEB)

    Mendiratta-Lala, Mishal [Henry Ford Hospital, Department of Radiology, Abdominal Interventional Radiology, 2799 West Grand Blvd, Detroit, MI 48202 (United States); Sheiman, Robert, E-mail: rsheiman@bidmc.harvard.edu [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States); Brook, Olga R. [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States); Gourtsoyianni, Sofia [King' s College London, St Thomas’ Hospital, Lambeth Palace Road, SE1 7EH London (United Kingdom); Mahadevan, Anand [Beth Israel Deaconess Hospital, Radiation Oncology, One Deaconess Road, Boston, MA 02215 (United States); Siewert, Bettina [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States)

    2014-04-15

    Objective: To determine if concomitant CT-guided biopsy and percutaneous fiducial seed placement in the lung can be performed in a selective patient population without increased complication or decreased success rates compared to either procedure alone. Materials and methods: An IRB approved retrospective analysis of 285 consecutive patients that underwent CT-guided placement of fiducial seeds in the lung alone (N = 63), with concomitant core biopsy (N = 53) or only core biopsy (N = 169) was performed. Variables compared included: patient demographics, lesion size, depth from pleura, needle size, number of passes through pleura, number and size of core biopsies, number of seeds placed and technical success rates. Statistical analysis was performed using univariate and multivariate pair-wise comparisons. Results: A pathologic diagnosis of malignancy was confirmed in all cases undergoing seed placement alone and seed placement with concurrent biopsy, and in 144 of the biopsy alone lesions. On univariate analysis, major complication rates were similar for all three groups as were lesion size, depth, number of pleural passes, and technical success. Pair-wise comparisons of the remaining variables demonstrated a significant younger age and smaller needle size in the biopsy only group, and less minor complications in the fiducial only group. Overall there were 80/285 (28.1%) minor and 29/285 (10.2%) major complications. All major complications leading to admission consisted of either pneumothorax or hemothorax, while minor complications included asymptomatic stable or resolving pneumothoraces, transient hemoptysis or small hemothoraces. Conclusions: A combined procedure of percutaneous pulmonary core biopsy and stereotactic seed placement can be performed without additional risk of a major complication when compared to performing these separately.

  6. CT-guided transgluteal biopsy for systematic sampling of the prostate in patients without rectal access: a 13-year single-center experience.

    Science.gov (United States)

    Olson, Michael C; Atwell, Thomas D; Mynderse, Lance A; King, Bernard F; Welch, Timothy; Goenka, Ajit H

    2017-08-01

    The purpose of our study was to examine the safety and diagnostic utility of transgluteal CT-guided prostate biopsy for prostate sampling in patients without rectal access. Seventy-three biopsies were performed in 65 patients over a 13-year period (2002-2015). Mean prostate-specific antigen (PSA) at biopsy was 7.8 ng/mL (range 0.37-31.5). Electronic medical records were reviewed for procedural details and complications. Mean PSA and number of cores in malignant and benign cohorts were compared with Student's t test. Technical success rate was 97.3% (71/73; mean cores 8, range 3-28). Of these, 43.6% (31/71) yielded malignancy (mean Gleason score 7, range 6-10) and 56.3% (40/71) yielded benign tissue. The only complication was an asymptomatic periprostatic hematoma (1/73; 1.4%). In 14 patients who underwent surgery, Gleason scores were concordant in 71.4% (10/14) and discordant in 28.6% (4/14; Gleason 6 on biopsy but Gleason 7 on surgical specimen). Mean effective radiation dose was 18.5 mSv (median 15.0, range 4.4-86.2). There was no significant difference in either mean PSA (p = 0.06) or number of core specimens (p = 0.33) between malignant and benign cohorts. CT-guided transgluteal prostate biopsy is highly safe and reliable for the detection of prostate cancer in men without rectal access. • Prostate cancer detection in men without rectal access is challenging. • CT-guided transgluteal prostate biopsy is safe and effective in these patients. • CT-guided biopsy may be particularly effective in diagnosing high-grade prostate cancer. • Unilateral CT-guided biopsy may be effective in patients with focal lesions. • The radiation exposure with this technique is acceptable.

  7. Percutaneous computed tomography-guided core needle biopsy of soft tissue tumors: results and correlation with surgical specimen analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Grigio, Henrique Ramos; Bitencourt, Almir Galvao Vieira; Pinto, Paula Nicole Vieira; Tyng, Chiang J.; Cunha, Isabela Werneck da; Aguiar Junior, Samuel; Lopes, Ademar, E-mail: chojniak@uol.com.br [Hospital A.C. Camargo, Sao Paulo, SP (Brazil)

    2012-09-15

    Objective: To evaluate the efficacy of percutaneous computed tomography (CT)-guided core needle biopsy of soft tissue tumors in obtaining appropriate samples for histological analysis, and compare its diagnosis with the results of the surgical pathology as available. Materials and Methods: The authors reviewed medical records, imaging and histological reports of 262 patients with soft-tissue tumors submitted to CT-guided core needle biopsy in an oncologic reference center between 2003 and 2009. Results: Appropriate samples were obtained in 215 (82.1%) out of the 262 patients. The most prevalent tumors were sarcomas (38.6%), metastatic carcinomas (28.8%), benign mesenchymal tumors (20.5%) and lymphomas (9.3%). Histological grading was feasible in 92.8% of sarcoma patients, with the majority of them (77.9%) being classified as high grade tumors. Out of the total sample, 116 patients (44.3%) underwent surgical excision and diagnosis confirmation. Core biopsy demonstrated 94.6% accuracy in the identification of sarcomas, with 96.4% sensitivity and 89.5% specificity. A significant intermethod agreement about histological grading was observed between core biopsy and surgical resection (p < 0.001; kappa = 0.75). Conclusion: CT-guided core needle biopsy demonstrated a high diagnostic accuracy in the evaluation of soft tissue tumors as well as in the histological grading of sarcomas, allowing an appropriate therapeutic planning (author)

  8. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: A preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Division of Interventional Radiology, Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncologic Diseases, Cagliari, Zip code 09100 (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy)

    2013-05-15

    Purpose: To report the data of our initial experience with CT-guided thin cryoprobes for percutaneous cryoablation (PCA) in patients with primary and secondary pulmonary tumors. Material and methods: CT-guided thin needles PCA was performed on 34 lung masses (11 NSCLC = 32%; 23 secondary lung malignancies = 68%) in 32 consecutive patients (24 men and 8 women; mean age 67 ± 10 years) not suitable for surgical resection. Lung masses were treated using two types of cryoprobes: IceRod and IceSeed able to obtain different size of iceball. The number of probes used ranged from 1 to 5 depending on the size of the tumor. After insertion of the cryoprobes into the lesion, the PCA were performed with two 2 (91%) or 3 (9%) cycles each of 12 min of freezing followed by a 4 min active thawing phase and a 4 min passive thawing phase for each one for all treatments. Results: All cryoablation sessions were successfully completed. All primary and metastatic lung tumors were ablated. No procedure-related deaths occurred. Morbidity consisted of 21% (7 of 34) pneumothorax and 3% (1 of 34) cases asymptomatic small pulmonary hemorrhage, respectively, all of CTCAE grade 1 (Common Terminology Criteria for Adverse Events). Low density of entire lesion, central necrosis and solid mass appearance were identify in 21 (62%), 7 (21%) and 6 (17%) of cryoablated tumors, respectively. No lymphadenopathy developed in the region of treated lesions. Technical success (complete lack of enhancement) was achieved in 82%, 97% and 91% of treated lesions at 1-, 3- and 6-months CT follow-up scan, respectively (p < .000). Comparing the tumor longest diameter between the baseline and at 6 month CT images, technical success was revealed in 92% cases (p < .000). Conclusion: Our preliminary experience suggests that PCA is a feasible treatment option. Well-designed clinical trials with a larger patient population are necessary to further investigate the long-term results and prognostic factors.

  9. Diagnostic feasibility and safety of CT-guided core biopsy for lung nodules less than or equal to 8 mm. A single-institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Ying-Yueh [Taipei Veterans General Hospital, Department of Radiology, Taipei (China); Chen, Chun-Ku [Taipei Veterans General Hospital, Department of Radiology, Taipei (China); National Yang-Ming University, School of Medicine, Taipei (China); National Yang-Ming University, Institute of Clinical Medicine, Taipei (China); Yeh, Yi-Chen [National Yang-Ming University, School of Medicine, Taipei (China); Taipei Veterans General Hospital, Department of Pathology and Laboratory Medicine, Taipei (China); Wu, Mei-Han [Taipei Veterans General Hospital, Department of Radiology, Taipei (China); National Yang-Ming University, School of Medicine, Taipei (China)

    2018-02-15

    This retrospective study evaluated the diagnostic yield and safety of CT-guided core biopsy of pulmonary nodules ≤8 mm. We determined the diagnostic yield and safety profile of CT-guided lung biopsies for 125 pulmonary nodules ≤8 mm. Pathological diagnoses were made by a combination of histopathological examination and imprint cytology. Results were compared with biopsy results for 134 pulmonary nodules >8 and ≤10 mm. Final diagnoses were established in 94 nodules ≤8 mm. The sensitivity, specificity and diagnostic accuracy of CT-guided core biopsy for nodules ≤8 mm were 87.1 % (61/70 nodules), 100 % (24/24) and 90.4 % (85/94), respectively. Diagnostic failure rates were comparable for nodules ≤8 mm and nodules >8 mm and ≤10 mm (9/94, 9.6 % and 7/111, 6.3 %, respectively, P=0.385). The rate of tube thoracostomy for nodules ≤8 mm was comparable to that for nodules >8 and ≤10 mm (1.6 % vs. 0.7 %, P=0.611). Nodules ≤6 mm had a higher non-diagnostic result rate of 15.4 % (6/39) than did nodules >8 and ≤10 mm (3.7 %, 5/134, P=0.017). CT-guided pulmonary biopsy is feasible for lung nodules ≤8 mm, especially those >6 mm, and has an acceptable diagnostic yield and safety profile. (orig.)

  10. Comparison of Battery-Powered and Manual Bone Biopsy Systems for Core Needle Biopsy of Sclerotic Bone Lesions.

    Science.gov (United States)

    Cohen, Micah G; McMahon, Colm J; Kung, Justin W; Wu, Jim S

    2016-05-01

    The purpose of this study was to compare manual and battery-powered bone biopsy systems for diagnostic yield and procedural factors during core needle biopsy of sclerotic bone lesions. A total of 155 consecutive CT-guided core needle biopsies of sclerotic bone lesions were performed at one institution from January 2006 to November 2014. Before March 2012, lesions were biopsied with manual bone drill systems. After March 2012, most biopsies were performed with a battery-powered system and either noncoaxial or coaxial biopsy needles. Diagnostic yield, crush artifact, CT procedure time, procedure radiation dose, conscious sedation dose, and complications were compared between the manual and battery-powered core needle biopsy systems by Fisher exact test and t test. One-way ANOVA was used for subgroup analysis of the two battery-powered systems for procedure time and radiation dose. The diagnostic yield for all sclerotic lesions was 60.0% (93/155) and was significantly higher with the battery-powered system (73.0% [27/37]) than with the manual systems (55.9% [66/118]) (p = 0.047). There was no significant difference between the two systems in terms of crush artifact, procedure time, radiation dose, conscious sedation administered, or complications. In subgroup analysis, the coaxial battery-powered biopsies had shorter procedure times (p = 0.01) and lower radiation doses (p = 0.002) than the coaxial manual systems, but the noncoaxial battery-powered biopsies had longer average procedure times and higher radiation doses than the coaxial manual systems. In biopsy of sclerotic bone lesions, use of a battery-powered bone drill system improves diagnostic yield over use of a manual system.

  11. Influence able and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique-Case Report, Systematic Literature Review, and a Technical Note

    International Nuclear Information System (INIS)

    Rott, G.; Boecker, F.

    2014-01-01

    Following the first case of a systemic air embolism due to percutaneous CT-guided lung biopsy in our clinic we analysed the literature regarding this matter in view of influence able or avoidable risk factors. A systematic review of literature reporting cases of systemic air embolism due to CT-guided lung biopsy was performed to find out whether prone positioning might be a risk factor regarding this issue. In addition, a technical note concerning coaxial biopsy practice is presented. Prone position seems to have relevance for the development and/or clinical manifestation of air embolism due to CT-guided lung biopsy and should be considered a risk factor, at least as far as lesions in the lower parts of the lung are concerned. Biopsies of small or cavitary lesions in coaxial technique should be performed using a hemo static valve.

  12. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    International Nuclear Information System (INIS)

    Pua, Uei; Chan, Stephen Yung-Wei

    2013-01-01

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  13. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Chan, Stephen Yung-Wei [Tan Tock Seng Hospital, Department of Anaesthesiology, Intensive Care and Pain Medicine (Singapore)

    2013-06-15

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  14. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A., E-mail: nour410@hotmail.com; Alsubhi, Mohammed, E-mail: mohammedal-subhi@yahoo.com; Emam, Ahmed, E-mail: morgan101002@hotmail.com; Lehnert, Thomas, E-mail: thomas.lehnert@kgu.de; Beeres, Martin, E-mail: beeres@gmx.net; Jacobi, Volkmar, E-mail: volkmar.jacobi@kgu.de; Gruber-Rouh, Tatjana, E-mail: tatjanagruber2004@yahoo.com; Scholtz, Jan-Erik, E-mail: janerikscholtz@gmail.com; Vogl, Thomas J., E-mail: t.vogl@em.uni-frankfurt.de; Naguib, Nagy N., E-mail: nagynnn@yahoo.com [Johan Wolfgang Goethe – University Hospital, Institute for Diagnostic and Interventional Radiology (Germany)

    2016-02-15

    PurposeTo assess the scope and determining risk factors related to the development of pneumothorax throughout CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques and the outcome of its management.Materials and MethodsThe study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD 5.2) from November 2008 to June 2013 in a retrospective design. Patients were classified according to lung biopsy technique into coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension, or refusal of the procedure. Risk factors related to the occurrence of pneumothorax were classified into: (a) Technical risk factors, (b) patient-related risk factors, and (c) lesion-associated risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher’s exact tests were used for statistical analysis. p values <0.05 were considered statistically significant.ResultsThe incidence of pneumothorax complicating CT-guided lung biopsy was less in the non-coaxial group (23.2 %, 77 out of 332) than the coaxial group (27 %, 86 out of 318). However, the difference in incidence between both groups was statistically insignificant (p = 0.14). Significant risk factors for the development of pneumothorax in both groups were emphysema (p < 0.001 in both groups), traversing a fissure with the biopsy needle (p value 0.005 in non-coaxial group and 0.001 in coaxial group), small lesion, less than 2 cm in diameter (p value of 0.02 in both groups), location of the lesion in the basal or mid sections of the lung (p = 0.003 and <0.001 in non-coaxial and coaxial groups, respectively), and increased needle track path within the lung tissue of more than 2.5 cm (p = 0.01 in both

  15. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients

    International Nuclear Information System (INIS)

    Nour-Eldin, Nour-Eldin A.; Alsubhi, Mohammed; Emam, Ahmed; Lehnert, Thomas; Beeres, Martin; Jacobi, Volkmar; Gruber-Rouh, Tatjana; Scholtz, Jan-Erik; Vogl, Thomas J.; Naguib, Nagy N.

    2016-01-01

    PurposeTo assess the scope and determining risk factors related to the development of pneumothorax throughout CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques and the outcome of its management.Materials and MethodsThe study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD 5.2) from November 2008 to June 2013 in a retrospective design. Patients were classified according to lung biopsy technique into coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension, or refusal of the procedure. Risk factors related to the occurrence of pneumothorax were classified into: (a) Technical risk factors, (b) patient-related risk factors, and (c) lesion-associated risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher’s exact tests were used for statistical analysis. p values <0.05 were considered statistically significant.ResultsThe incidence of pneumothorax complicating CT-guided lung biopsy was less in the non-coaxial group (23.2 %, 77 out of 332) than the coaxial group (27 %, 86 out of 318). However, the difference in incidence between both groups was statistically insignificant (p = 0.14). Significant risk factors for the development of pneumothorax in both groups were emphysema (p < 0.001 in both groups), traversing a fissure with the biopsy needle (p value 0.005 in non-coaxial group and 0.001 in coaxial group), small lesion, less than 2 cm in diameter (p value of 0.02 in both groups), location of the lesion in the basal or mid sections of the lung (p = 0.003 and <0.001 in non-coaxial and coaxial groups, respectively), and increased needle track path within the lung tissue of more than 2.5 cm (p = 0.01 in both

  16. EFFICACY OF IMMUNOHISTOCHEMISTRY IN PROSTATE NEEDLE BIOPSIES

    Directory of Open Access Journals (Sweden)

    Tameem Afroz

    2016-10-01

    Full Text Available BACKGROUND Prostate needle biopsies can pose a major diagnostic challenge when it comes to differentiating adenocarcinoma and its variants from its benign mimics. In needle biopsies, when the suspicious focus is small, morphological features may not suffice to differentiate it from its morphologic mimics like atrophy, basal cell hyperplasia, reactive inflammatory changes, seminal vesicles and adenosis. Immunohistochemical marker for basal cells, p63 and prostate cancer specific marker, Alpha-Methylacyl-CoA Racemase (AMACR help in overcoming such diagnostic dilemmas. MATERIALS AND METHODS We analysed 157 prostate core needle biopsies over a period of 2 years. Routine Hematoxylin and Eosin (H and E sections and immunohistochemical markers for basal cells (p63 and prostate cancer specific marker (AMACR were used. Prospective study was done on prostate needle core biopsies. Biopsy was done under ultrasound guidance with an 18-gauge needle. Biopsy was done in patients with raised serum PSA levels for exclusion of prostate carcinoma. RESULTS Over a period of two years, 157 prostate core needle biopsies were studied. 83 were benign lesions comprising 69 benign prostatic hyperplasias, five basal cell hyperplasias, four granulomatous lesions and three showed atrophic changes. Two biopsies morphologically resembled seminal vesicles. Prostate cancer specific marker, AMACR was negative in all, but two lesions. In these two lesions, it showed weak nonspecific staining. Basal cell marker p63 showed a continuous staining pattern highlighting the basal cells in all the 69 cases of benign prostatic hyperplasia, 5 cases of basal hyperplasia showed positivity in all the hyperplastic basal cells. In the two cases of seminal vesicles, it showed intense basal cell positivity. It showed a discontinuous pattern in two of the four granulomatous lesions and showed a weak, but a continuous staining pattern in the atrophic lesions. 74 were adenocarcinomas; the predominant

  17. Ultrasound-guided fine needle aspiration versus core needle biopsy: comparison of post-biopsy hematoma rates and risk factors.

    Science.gov (United States)

    Chae, In Hye; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

    2017-07-01

    To compare post-biopsy hematoma rates between ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy, and to investigate risk factors for post-biopsy hematoma. A total of 5304 thyroid nodules which underwent ultrasound guided biopsy were included in this retrospective study. We compared clinical and US features between patients with and without post-biopsy hematoma. Associations between these features and post-biopsy hematoma were analyzed. Post-biopsy hematoma rate was 0.8% (43/5121) for ultrasound guided-fine needle aspiration and 4.9% (9/183) for ultrasound guided-core needle biopsy (P core needle biopsy (9/179, 5.0%) than with ultrasound guided-fine needle aspiration (9/1138, 0.8%) (P core needle biopsy was the only significant risk factor for post-biopsy hematoma (adjusted Odds Ratio, 6.458, P core needle biopsy than in ultrasound guided-fine needle aspiration and ultrasound guided-core needle biopsy was the only independent factor of post-biopsy hematoma in thyroid nodules.

  18. A trucut biopsy needle for bipolar radiofrequency ablation of needle tract: a proof-of-concept experiment.

    Science.gov (United States)

    Bruners, Philipp; Penzkofer, Tobias; Isfort, Peter; Pfeffer, Jochen; Schmitz-Rode, Thomas; Günther, Rolf W; Mahnken, Andreas H

    2010-08-01

    To develop a trucut biopsy needle featuring two electrodes that allow for bipolar radiofrequency (RF) coagulation of the puncture tract. We modified a 14-G trucut biopsy needle to contain two insulated electrodes and connected the device to an RF generator. Biopsies in ex vivo porcine liver and kidney were performed. The puncture tract was coagulated by using different RF energy settings (5 W, 10 W, 20 W). Tissue specimens were dissected along the puncture tract and the coagulation area was macroscopically evaluated. CT-guided in vivo liver and kidney biopsies were performed in two domestic pigs. Lengths of specimens were measured. Post-biopsy contrast-enhanced CT examinations were performed to rule out biopsy-related bleeding. Animals were euthanised and coagulation areas macroscopically explored. The mean diameters of the coagulated area around the ex vivo biopsy tract were 4.2 +/- 1.1 mm (5 W), 6.0 +/- 2.0 mm (10 W) and 5.2 +/- 0.51 mm (20 W) in liver and 5.0 +/- 0.7 mm (5 W), 6.6 +/- 0.9 (10 W) and 6.0 +/- 2.0 mm (20 W) in kidney. After biopsies CT revealed no bleeding. Mean maximum coagulation diameters were 10.1 +/- 4.6 mm (10 W) in liver and 6.0 +/- 2.5 mm (10 W) in kidney. Mean length of the specimens was 12.2 +/- 4.4 mm in kidney and 11.1 +/- 3.6 mm in liver tissue. Bipolar RF biopsy is a promising tool for tract coagulation after percutaneous biopsy.

  19. A trucut biopsy needle for bipolar radiofrequency ablation of needle tract: a proof-of-concept experiment

    International Nuclear Information System (INIS)

    Bruners, Philipp; Penzkofer, Tobias; Isfort, Peter; Pfeffer, Jochen; Schmitz-Rode, Thomas; Guenther, Rolf W.; Mahnken, Andreas H.

    2010-01-01

    To develop a trucut biopsy needle featuring two electrodes that allow for bipolar radiofrequency (RF) coagulation of the puncture tract. We modified a 14-G trucut biopsy needle to contain two insulated electrodes and connected the device to an RF generator. Biopsies in ex vivo porcine liver and kidney were performed. The puncture tract was coagulated by using different RF energy settings (5 W, 10 W, 20 W). Tissue specimens were dissected along the puncture tract and the coagulation area was macroscopically evaluated. CT-guided in vivo liver and kidney biopsies were performed in two domestic pigs. Lengths of specimens were measured. Post-biopsy contrast-enhanced CT examinations were performed to rule out biopsy-related bleeding. Animals were euthanised and coagulation areas macroscopically explored. The mean diameters of the coagulated area around the ex vivo biopsy tract were 4.2 ± 1.1 mm (5 W), 6.0 ± 2.0 mm (10 W) and 5.2 ± 0.51 mm (20 W) in liver and 5.0 ± 0.7 mm (5 W), 6.6 ± 0.9 (10 W) and 6.0 ± 2.0 mm (20 W) in kidney. After biopsies CT revealed no bleeding. Mean maximum coagulation diameters were 10.1 ± 4.6 mm (10 W) in liver and 6.0 ± 2.5 mm (10 W) in kidney. Mean length of the specimens was 12.2 ± 4.4 mm in kidney and 11.1 ± 3.6 mm in liver tissue. Bipolar RF biopsy is a promising tool for tract coagulation after percutaneous biopsy. (orig.)

  20. Protective Capnothorax During Transthoracic Needle Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, John, E-mail: jokavana@tcd.ie; Siemienowicz, Miranda L.; Lyen, Stephen; Kandel, Sonja; Rogalla, Patrik [University of Toronto, Division of Cardiothoracic Imaging, Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital (Canada)

    2017-04-15

    PurposeTransthoracic needle biopsy (TTNB) is an established procedure in the management of pulmonary nodules. The most common complications are directly related to crossing the lung or visceral pleura during the biopsy. In this study, we describe the use of carbon dioxide instead of room air to create a protective “capnothorax” during TTNB.Materials and MethodsFive patients underwent creation of a capnothorax during TTNB. Parameters recorded were location and size of target, distance from pleura, length of procedure, volume of carbon dioxide, periprocedural complications and biopsy result.ResultsInduction of capnothorax was successful in all cases. In two patients, a continuous infusion of carbon dioxide was required to maintain an adequate volume of intrapleural gas. In two patients, the carbon dioxide resolved spontaneously and in the remaining patients it was aspirated at the end of the procedure. All biopsies were diagnostic with no periprocedural or postprocedural complications.ConclusionThis study suggests that protective iatrogenic capnothorax is a safe and effective technique during TTNB. The intrinsic properties and availability of carbon dioxide make it an attractive alternative to room air.

  1. Computed-Tomography-Guided Percutaneous Core Needle Biopsies of Suspected Malignant Lymphomas: Impact of Biopsy, Lesion, and Patient Parameters on Diagnostic Yield

    International Nuclear Information System (INIS)

    Hesselmann, V.; Zaehringer, M.; Krug, B.; Wesselmann, C.; Haferkamp, K.; Wickenhauser, C.; Lackner, K.

    2004-01-01

    Purpose: To investigate the diagnostic yield of core needle biopsy in patients with malignant lymphoma. Material and Methods: Computed-tomography-guided core needle biopsies in patients with malignant lymphoma performed in the period 1996 to 2001 were evaluated retrospectively. A biopsy was considered as 'fully diagnostic' if a histological diagnosis, including the histologic subtype in the event of malignant lymphoma, was achieved and the clinical course and CT follow-up of at least 6 months confirmed the biopsy results. A biopsy was regarded as 'partly diagnostic' if histological work-up defined malignant lymphoma but not the histological subtype, and if histological diagnosis bore therapeutic relevance. Diagnostic yield was correlated with features such as size of specimen, location and depth of the target lesion, and experience of the investigator. Results: 45 biopsies were performed in 40 patients. With respect to definite histopathological diagnosis, 31 biopsies (68.9%) were diagnostic and 14 (31.1%) non-diagnostic. In 4 cases (8.8%), biopsies yielded partly diagnostic results, since therapy could be scheduled after biopsy without final sub-classification. Statistical analysis of biopsy parameters revealed that sample sizes were significantly larger in the diagnostic group. Conclusion: CT-guided biopsy can be considered as an alternative for lymphoma diagnosis and should be the first interventional procedure. The most important parameter for diagnostic success is the size of the specimen

  2. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors

    Directory of Open Access Journals (Sweden)

    In Hye Song

    2015-03-01

    Full Text Available Background: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

  3. [Closed needle-biopsy in the diagnosis of neoplasms].

    Science.gov (United States)

    Sforza, M; Perelli Ercolini, M; Beani, G

    1979-04-01

    The AA. demonstrate with this communication the validity of the needle biopsie for the diagnosis of neoplasms. They had used it for the breast, thyroid, flg and some other superficial tumefactions. In the mass-screening for the feminine neoplasms the clinical examination and the needle biopsy are very good method for a careful diagnosis.

  4. Complications in CT-guided, semi-automatic coaxial core biopsy of potentially malignant pulmonary lesions; Komplikationen bei CT-gesteuerter, koaxialer Stanzbiopsie malignomverdaechtiger Lungenherde in halbautomatischer Technik

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, R. [Klinik Loewenstein (Germany). Dept. of Radiology; Seebacher, G.; Enderes, B.; Kugler, G.; Graeter, T.P. [Klinik Loewenstein (Germany). Dept. of Thoracic and Vascular Surgery; Fischer, J.R. [Klinik Loewenstein (Germany). Dept. of Oncology

    2015-08-15

    Histological verification of pulmonary lesions is important to ensure correct treatment. Computed tomographic (CT) transthoracic core biopsy is a well-established procedure for this. Comparison of available studies is difficult though, as technical and patient characteristics vary. Using a standardized biopsy technique, we evaluated our results for CT-guided coaxial core biopsy in a semi-automatic technique. Within 2 years, 664 consecutive transpulmonary biopsies were analyzed retrospectively. All interventions were performed using a 17/18G semi-automatic core biopsy system (4 to 8 specimens). The incidence of complications and technical and patient-dependent risk factors were evaluated. Comparing the histology with the final diagnosis, the sensitivity was 96.3 %, and the specificity was 100 %. 24 procedures were not diagnostic. In all others immunohistological staining was possible. The main complication was pneumothorax (PT, 21.7 %), with chest tube insertion in 6 % of the procedures (n = 40). Bleeding without therapeutic consequences was seen in 43 patients. There was no patient mortality. The rate of PT with chest tube insertion was 9.6 % in emphysema patients and 2.8 % without emphysema (p = 0.001). Smokers with emphysema had a 5 times higher risk of developing PT (p = 0.001). Correlation of tumor size or biopsy angle and the risk of PT was not significant. The risk of developing a PT was associated with an increasing intrapulmonary depth of the lesion (p = 0.001). CT-guided, semiautomatic coaxial core biopsy of the lung is a safe diagnostic procedure. The rate of major complications is low, and the sensitivity and specificity of the procedure are high. Smokers with emphysema are at a significantly higher risk of developing pneumothorax and should be monitored accordingly.

  5. Computed Tomography-Guided Core-Needle Biopsy Specimens Demonstrate Epidermal Growth Factor Receptor Mutations in Patients with Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Chen, C.M.; Chang, J.W.C.; Cheung, Y.C.; Lin, G.; Hsieh, J.J.; Hsu, T.; Huang, S.F.

    2008-01-01

    Background: Target therapy with a new class of epidermal growth factor receptor (EGFR) inhibitors shows improved clinical response in EGFR gene-mutated lung cancers. Purpose: To evaluate the use of computed tomography (CT)-guided core-needle biopsy specimens for the assessment of EGFR gene mutation in non-small-cell lung cancer (NSCLC). Material and Methods: Seventeen (nine males, eight females) patients with advanced NSCLC were enrolled in this study. All patients underwent CT-guided core-needle biopsy of the lung tumor prior to treatment with the EGFR inhibitor gefitinib. There were no life-threatening complications of biopsy. The specimens were sent fresh-frozen for EGFR mutation analysis and histopathological study. Results: There were 12 (70.6%) EGFR gene mutants and five (29.4%) nonmutants. The objective response rate to gefitinib therapy was 73.3% (11 of 15 patients), with 91.7% (11 of 12 mutants) for the mutant group and 0% for the nonmutant group. Conclusion: CT-guided core-needle biopsy of advanced NSCLC enables the acquisition of sufficient tissue for EGFR gene mutation analysis

  6. When size matters: diagnostic value of kidney biopsy according to the gauge of the biopsy needle.

    Science.gov (United States)

    Roth, Rachel; Parikh, Samir; Makey, Dayanand; Foster, Jamison; Rozenblit, Grigory; Satoskar, Anjali; Nadasdy, Gyongyi; Von Visger, Jon; Hebert, Lee; Rovin, Brad H; Nadasdy, Tibor; Brodsky, Sergey V

    2013-01-01

    Kidney biopsy is a vital tool in the diagnosis of kidney disease. Although it has become a routine procedure, it is not complication-free. Some serious complications of percutaneous kidney biopsy include retroperitoneal hemorrhage and death. There is an increased belief that smaller biopsy needle size results in a lower complication rate. As renal pathologists, we witness an increased number of kidney biopsies performed with a small needle size (as low as gauge 22), which results in inadequate tissue sampling and often non-diagnostic biopsy results. Herein we report the diagnostic value of kidney biopsies according to the size of the biopsy needles. We performed kidney biopsies from nephrectomy specimens using biopsy needles of different sizes. Morphologic parameters were analyzed. We found that biopsies performed by small needles (gauges 20 and 22) contain significantly lower numbers of glomeruli and blood vessels, which limits pathologic evaluation. Data from our institution do not show differences in kidney biopsy complication rates between 16- and 18-gauge needles. Our data indicate that small biopsy needles do not provide sufficient material for diagnosis, and they increase the likelihood for a repeat biopsy. Copyright © 2013 S. Karger AG, Basel.

  7. Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F.; Takaki, H. [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Laskhmanan, M. [Perfint Healthcare Inc (India); Durack, J. C.; Erinjeri, J. P.; Getrajdman, G. I.; Maybody, M.; Sofocleous, C. T.; Solomon, S. B.; Srimathveeravalli, G., E-mail: srimaths@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

    2015-10-15

    PurposeTo compare CT fluoroscopy-guided manual and CT-guided robotic positioning system (RPS)-assisted needle placement by experienced IR physicians to targets in swine liver.Materials and MethodsManual and RPS-assisted needle placement was performed by six experienced IR physicians to four 5 mm fiducial seeds placed in swine liver (n = 6). Placement performance was assessed for placement accuracy, procedure time, number of confirmatory scans, needle manipulations, and procedure radiation dose. Intra-modality difference in performance for each physician was assessed using paired t test. Inter-physician performance variation for each modality was analyzed using Kruskal–Wallis test.ResultsPaired comparison of manual and RPS-assisted placements to a target by the same physician indicated accuracy outcomes was not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p = 0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77 mGy/cm; RPS: 636.4 mGy/cm; p = 0.03), required more confirmation scans (manual: 6.6; RPS: 1.6; p < 0.0001) and needle manipulations (manual: 4.6; RPS: 0.4; p < 0.0001). Procedure time for RPS was longer than manual placement (manual: 6.12 min; RPS: 9.7 min; p = 0.0003). Comparison of inter-physician performance during manual placement indicated significant differences in the time taken to complete placements (p = 0.008) and number of repositions (p = 0.04) but not in other study measures (p > 0.05). Comparison of inter-physician performance during RPS-assisted placement suggested statistically significant differences in procedure time (p = 0.02) and not in other study measures (p > 0.05).ConclusionsCT-guided RPS-assisted needle placement reduced radiation dose, number of confirmatory scans, and needle manipulations when compared to manual needle placement by experienced IR physicians, with equivalent accuracy.

  8. Comparison of CT Fluoroscopy-Guided Manual and CT-Guided Robotic Positioning System for In Vivo Needle Placements in Swine Liver

    International Nuclear Information System (INIS)

    Cornelis, F.; Takaki, H.; Laskhmanan, M.; Durack, J. C.; Erinjeri, J. P.; Getrajdman, G. I.; Maybody, M.; Sofocleous, C. T.; Solomon, S. B.; Srimathveeravalli, G.

    2015-01-01

    PurposeTo compare CT fluoroscopy-guided manual and CT-guided robotic positioning system (RPS)-assisted needle placement by experienced IR physicians to targets in swine liver.Materials and MethodsManual and RPS-assisted needle placement was performed by six experienced IR physicians to four 5 mm fiducial seeds placed in swine liver (n = 6). Placement performance was assessed for placement accuracy, procedure time, number of confirmatory scans, needle manipulations, and procedure radiation dose. Intra-modality difference in performance for each physician was assessed using paired t test. Inter-physician performance variation for each modality was analyzed using Kruskal–Wallis test.ResultsPaired comparison of manual and RPS-assisted placements to a target by the same physician indicated accuracy outcomes was not statistically different (manual: 4.53 mm; RPS: 4.66 mm; p = 0.41), but manual placement resulted in higher total radiation dose (manual: 1075.77 mGy/cm; RPS: 636.4 mGy/cm; p = 0.03), required more confirmation scans (manual: 6.6; RPS: 1.6; p < 0.0001) and needle manipulations (manual: 4.6; RPS: 0.4; p < 0.0001). Procedure time for RPS was longer than manual placement (manual: 6.12 min; RPS: 9.7 min; p = 0.0003). Comparison of inter-physician performance during manual placement indicated significant differences in the time taken to complete placements (p = 0.008) and number of repositions (p = 0.04) but not in other study measures (p > 0.05). Comparison of inter-physician performance during RPS-assisted placement suggested statistically significant differences in procedure time (p = 0.02) and not in other study measures (p > 0.05).ConclusionsCT-guided RPS-assisted needle placement reduced radiation dose, number of confirmatory scans, and needle manipulations when compared to manual needle placement by experienced IR physicians, with equivalent accuracy

  9. PET/CT-guided percutaneous biopsy of FDG-avid metastatic bone lesions in patients with advanced lung cancer: a safe and effective technique

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Wei; Hao, Bing; Chen, Hao-jun; Zhao, Long; Luo, Zuo-ming; Wu, Hua; Sun, Long [The First Affiliated Hospital of Xiamen University, Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, Xiamen (China)

    2017-01-15

    {sup 18}F-FDG PET/CT should be performed before a diagnostic biopsy site is chosen in patients with a high clinical suspicion of aggressive, advanced tumour. The aim of this study was to evaluate the safety and efficacy of {sup 18}F-FDG PET/CT in guiding biopsy of bone metastases in patients with advanced lung cancer. PET/CT-guided percutaneous core biopsies were performed in 51 consecutive patients with suspected lung cancer and {sup 18}F-FDG-avid bone lesions after whole-body {sup 18}F-FDG PET/CT scans. Generally, one tissue sample was obtained from each patient. The final diagnoses were established on the basis of the histology results. The histopathological and molecular testing results were systematically evaluated. A total of 53 samples were obtained for histological examination or molecular testing as a second biopsy was required in two patients in whom the pathological diagnosis was unclear following the first biopsy. The pathological diagnosis and lung cancer classification were confirmed in 48 patients. The epidermal growth factor receptor mutation status was determined in 23 biopsies, and the mutation rate was 30.4 % (7/23). The anaplastic lymphoma kinase mutation status was determined in 19 biopsies, and the mutation rate was 31.6 % (6/19). Two of the 51 biopsies were positive for non-Hodgkin's lymphoma and one was positive for metastatic renal cell carcinoma. The first-time diagnostic success rate of biopsy was 96.1 % (49/51) and the overall diagnostic success rate and sensitivity were 100 %. All 51 patients were eventually confirmed as having stage IV disease. No serious complications were encountered and the average biopsy time was 30 min. PET/CT-guided percutaneous biopsy of {sup 18}F-FDG-avid bone metastases is an effective and safe method that yields a high diagnostic success rate in the evaluation of hypermetabolic bone lesions in patients with suspected advanced lung cancer. (orig.)

  10. Current status of core needle biopsy of the thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jung Hwan [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    Thyroid nodules are a common clinical problem. Fine-needle aspiration (FNA) and large-needle biopsy have been used to diagnose thyroid nodules. Before the 1980s, large-needle biopsy was the standard procedure for the thyroid, but FNA became the standard diagnostic tool in the 1980s because it is a safe procedure that leads to accurate diagnoses. With advances in core needle biopsy (CNB) devices (i.e., spring-activated core needles) and development of high-resolution ultrasound, it has become possible to make accurate diagnoses while minimizing complications. Although 18- to 21-gauge core needles can be used to biopsy thyroid nodules, 18-gauge needles are most commonly used in Korea. The relationships among the size of the needle, the number of core specimens, and diagnostic accuracy have not yet been conclusively established, but the general tendency is that thinner needles cause less damage to the normal thyroid, but allow a smaller amount of thyroid tissue to be biopsied to be obtained. These relationships may be validated in the future.

  11. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

    International Nuclear Information System (INIS)

    Li Zhen; Han Xinwei; Jiao Dechao; Ren Jianzhuang; Su Yu; Ye Hui

    2011-01-01

    Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

  12. CT-guided transgluteal biopsy for systematic sampling of the prostate in patients without rectal access: a 13-year single-center experience

    Energy Technology Data Exchange (ETDEWEB)

    Olson, Michael C.; Atwell, Thomas D.; King, Bernard F.; Welch, Timothy; Goenka, Ajit H. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Mynderse, Lance A. [Mayo Clinic, Department of Urology, Rochester, MN (United States)

    2017-08-15

    The purpose of our study was to examine the safety and diagnostic utility of transgluteal CT-guided prostate biopsy for prostate sampling in patients without rectal access. Seventy-three biopsies were performed in 65 patients over a 13-year period (2002-2015). Mean prostate-specific antigen (PSA) at biopsy was 7.8 ng/mL (range 0.37-31.5). Electronic medical records were reviewed for procedural details and complications. Mean PSA and number of cores in malignant and benign cohorts were compared with Student's t test. Technical success rate was 97.3% (71/73; mean cores 8, range 3-28). Of these, 43.6% (31/71) yielded malignancy (mean Gleason score 7, range 6-10) and 56.3% (40/71) yielded benign tissue. The only complication was an asymptomatic periprostatic hematoma (1/73; 1.4%). In 14 patients who underwent surgery, Gleason scores were concordant in 71.4% (10/14) and discordant in 28.6% (4/14; Gleason 6 on biopsy but Gleason 7 on surgical specimen). Mean effective radiation dose was 18.5 mSv (median 15.0, range 4.4-86.2). There was no significant difference in either mean PSA (p = 0.06) or number of core specimens (p = 0.33) between malignant and benign cohorts. CT-guided transgluteal prostate biopsy is highly safe and reliable for the detection of prostate cancer in men without rectal access. (orig.)

  13. Histopathologic quality of prostate core biopsy specimens: comparison of an MR-compatible biopsy needle and a ferromagnetic biopsy needle used for ultrasound-guided prostate biopsy

    International Nuclear Information System (INIS)

    Franiel, T.; Hamm, B.; Beyersdorff, D.; Fritzsche, F.; Staack, A.; Rost, J.

    2006-01-01

    Purpose: The histopathologic quality of core biopsy specimens obtained via MRI-guided prostate biopsy using a 16G MR-compatible needle was compared to that of biopsies obtained via ultrasound-guided biopsy using a conventional 18G stainless steel biopsy needle. Material and Methods: A retrospective analysis was performed for a total of 247 transrectal prostate biopsy specimens obtained from 32 patients. A total of 117 tissue cores were obtained from 15 patients (PSA of 10.8 ng/ml, age 64 years) who underwent an MRI-guided prostate biopsy using a 16G (1.7 mm) MR-compatible biopsy needle made of titanium alloy. The remaining 130 tissue cores were obtained from 17 patients (PSA of 6.7 ng/ml, age 68 years) who underwent a transrectal ultrasound-guided prostate biopsy using an 18G (1.3 mm) ferromagnetic stainless steel biopsy needle. The length and width of the histologic sections prepared from the tissue cores were measured to calculate the area. The histopathologic quality of the specimens was assessed microscopically using tissue fragmentation, the presence of crush artifacts, and the overall assessability as criteria. Each of these features was assigned a score from 0 to 3. All 3 features contributed equally to the overall score which ranged from 0 (no tissue) to 9 (optimal quality). Results: The overall quality scores assigned to the biopsies obtained with a 16G MR-compatible needle and an 18G ferromagnetic needle can be considered to be equivalent to a mean difference between patient related median scores of the specimens of -0.05 (95% confidence interval [-0.46; 0.36]) and a given equivalence limit of 1. The MRI biopsies showed more tissue fragmentation (p=0.001) but fewer crush artifacts (p=0.022) while the assessability did not differ significantly between the two needle types (p=0.064). There was also no significant difference in the calculated areas of the tissue cores (p=0.236). According to the different calibers of the biopsy needles, the lengths (p=0

  14. Effects of percutaneous needle liver biopsy on dairy cow behaviour

    DEFF Research Database (Denmark)

    Mølgaard, Lene; Damgaard, Birthe Marie; Bjerre-Harpøth, Vibeke

    2012-01-01

    In cattle, percutaneous needle liver biopsy is used for scientific examination of liver metabolism. The impact of the biopsy procedure is, however, poorly investigated. Our aim was to examine the behaviour of dairy cows during and after liver biopsy. Data were collected from 18 dry cows....... Percutaneous needle liver biopsies (after administration of local anaesthesia (2% Procaine)) and blood samples were taken during restraining. During the control treatment, animals were restrained and blood sampled. During the biopsy procedure, cows showed increased restlessness (P = 0.008), frequency of head...... behavioural changes for up to 19 h – and particularly for behaviour previously associated with pain. Even though the exact welfare impact of percutaneous needle liver biopsies in cows is not known, and the magnitude of the behavioural changes was limited, pain always has negative effects on animal welfare...

  15. CT-guided diagnostic interventions for classification of focal hepatic lesions: A comparison of 14 G- and 18 G-large bore cutting needles; CT-gesteuerte perkutane Biopsien zur Klassifizierung von fokalen Leberlaesionen: Vergleich zwischen 14 G- und 18 G-Stanzbiopsienadeln

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Piroth, W.; Staatz, G.; Adam, G.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)

    1999-07-01

    Purpose: Analysis and comparison of CT-guided 14- and 18-gauge cutting needle biopsies to accurately assess focal liver disease. Methods: The data of 272 CT-guided biopsies in 268 patients were evaluated retrospectively with regard to sensitivity, specificity and complication rate of the chosen needle caliber in differentiating between benign and malignant disease as well as in the ability to determine specific cell types in the various disorders. A 14-gauge (G) needle was used in 101 (37.1%) cases, in 18-g needle biopsy was performed in 171 (62.9%) cases. The Fisher exact test was employed for statistical analysis. Results: Cutting needle biopsy yielded sufficient histologic material in 267 of 272 (98.2%) cases. Correct diagnosis of malignancy was established in 178 of 191 (93.2%) lesions, 73 of 76 (96.1%) disorders were accurately defined as benign, resulting in an overall value of 94.0% (251 of 267). Of these 251 biopsies a definite histological diagnosis could be determined in 90.6% of the cases employing a 14 G needle and in 90.3% using an 18-g needle. The sensitivity, specificity and rate of complications were 94.8%, 92.0%%, 3.0% for the 14-g needle and 92.7%, 97.6%, 0.6% for the 18-g needle, respectively. There were no statistically significant differences with regard to the needle size. Conclusions: CT-guided biopsy of hepatic lesions with the 18-g biopsy needle is of equivalent diagnostic accuracy when compared with the 14-g needle. (orig.) [Deutsch] Ziel: Analyse und Vergleich CT-gesteuerter Fein- und Grobstanzbiopsien zur definitiven Abklaerung unklarer fokaler Leberveraenderungen. Methoden: Die Daten von insgesamt 272 CT-gefuehrten Punktionen an 268 Patienten wurden retrospektiv hinsichtlich Sensitivitaet, Spezifitaet und Komplikationsrate zur Dignitaetsbestimmung und Faehigkeit zur artdiagnostischen Einordnung unter Beruecksichtigung der Groesse der gewaehlten Punktionsnadel ueberprueft und ausgewertet. In 101 (37,1%) Faellen wurde eine 14 Gauge (G

  16. Real-time fluoroscopic needle guidance in the interventional radiology suite using navigational software for percutaneous bone biopsies in children

    Energy Technology Data Exchange (ETDEWEB)

    Shellikeri, Sphoorti; Srinivasan, Abhay; Krishnamurthy, Ganesh; Vatsky, Seth; Zhu, Xiaowei; Keller, Marc S.; Cahill, Anne Marie [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Setser, Randolph M. [Siemens Medical Solutions USA, Inc., Hoffman Estates, IL (United States); Hwang, Tiffany J. [University of Southern California, Keck School of Medicine, Los Angeles, CA (United States); Girard, Erin [Siemens Medical Solutions USA, Inc., Princeton, NJ (United States)

    2017-07-15

    Navigational software provides real-time fluoroscopic needle guidance for percutaneous procedures in the Interventional Radiology (IR) suite. We describe our experience with navigational software for pediatric percutaneous bone biopsies in the IR suite and compare technical success, diagnostic accuracy, radiation dose and procedure time with that of CT-guided biopsies. Pediatric bone biopsies performed using navigational software (Syngo iGuide, Siemens Healthcare) from 2011 to 2016 were prospectively included and anatomically matched CT-guided bone biopsies from 2008 to 2016 were retrospectively reviewed with institutional review board approval. C-arm CT protocols used for navigational software-assisted cases included institution-developed low-dose (0.1/0.17 μGy/projection), regular-dose (0.36 μGy/projection), or a combination of low-dose/regular-dose protocols. Estimated effective radiation dose and procedure times were compared between software-assisted and CT-guided biopsies. Twenty-six patients (15 male; mean age: 10 years) underwent software-assisted biopsies (15 pelvic, 7 lumbar and 4 lower extremity) and 33 patients (13 male; mean age: 9 years) underwent CT-guided biopsies (22 pelvic, 7 lumbar and 4 lower extremity). Both modality biopsies resulted in a 100% technical success rate. Twenty-five of 26 (96%) software-assisted and 29/33 (88%) CT-guided biopsies were diagnostic. Overall, the effective radiation dose was significantly lower in software-assisted than CT-guided cases (3.0±3.4 vs. 6.6±7.7 mSv, P=0.02). The effective dose difference was most dramatic in software-assisted cases using low-dose C-arm CT (1.2±1.8 vs. 6.6±7.7 mSv, P=0.001) or combined low-dose/regular-dose C-arm CT (1.9±2.4 vs. 6.6±7.7 mSv, P=0.04), whereas effective dose was comparable in software-assisted cases using regular-dose C-arm CT (6.0±3.5 vs. 6.6±7.7 mSv, P=0.7). Mean procedure time was significantly lower for software-assisted cases (91±54 vs. 141±68 min, P=0

  17. Transrectal ultrasound and needle biopsy of the prostate

    Directory of Open Access Journals (Sweden)

    Tomaž Smrkolj

    2016-01-01

    Full Text Available In the last 25 years widespread use of prostatic specific antigen caused a stage migration of prostate cancer towards localized disease at diagnosis, which resulted in transrectal ultrasound biopsy to become standard in clinical practice. Transrectal ultrasound examination of the prostate is used to diagnose benign prostatic diseases, e.g. benign prostatic enlargement, prostatitis, prostatic and seminal vesicle cysts. It is also important in detection of obstructive causes of male infertility. Transrectal ultrasound examination is performed most often in needle biopsy for prostate cancer diagnosis. Besides guiding systematic tissue core biopsy, characteristic ultrasound changes enables target biopsies of suspect areas. The article describes indications, contraindications, antibiotic prophylaxis, various biopsy templates and complications of the needle biopsy. Experience with transrectal ultrasound guided biopsy at Department of urology at University medical center in Ljubljana is presented.

  18. Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities

    International Nuclear Information System (INIS)

    Cornelis, F.; Silk, M.; Takaki, H.; Durack, J.C.; Erinjeri, J.P.; Sofocleous, C.T.; Siegelbaum, R.H.; Maybody, M.; Solomon, S.B.; Schoder, H.

    2014-01-01

    We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18 F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging. From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed. Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106). Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. (orig.)

  19. Biopsy

    Science.gov (United States)

    ... Oropharynx lesion biopsy Pleural needle biopsy Polyp biopsy Rectal biopsy Renal biopsy Salivary gland biopsy Skin lesion ... Copyright 1997-2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing ...

  20. Usefulness of CT fluoroscopy-guided percutaneous needle biopsy in the presence of pneumothorax during biopsy

    International Nuclear Information System (INIS)

    O, Dong Hyun; Cho, Young Jun; Park, Yong Sung; Hwang, Cheol Mok; Kim, Keum Won; Kim, Ji Hyung

    2006-01-01

    When pneumothorax occurs during a percutaneous needle biopsy, the radiologist usually stops the biopsy. We evaluated the usefulness of computed tomographic (CT) fluoroscopy-guided percutaneous needle biopsy in the presence of pneumothorax during biopsy. We performed 288 CT fluoroscopy guided percutaneous needle biopsies to diagnose the pulmonary nodules. Twenty two of these patients had pneumothorax that occurred during the biopsy without obtaining an adequate specimen. After pneumothorax occurred, we performed immediate CT fluoroscopy guided percutaneous needle biopsies using an 18-gauge cutting needle. We evaluated the success rate of the biopsies and also whether or not the pneumothorax progressed. We classified these patients into two groups according to whether the pneumothorax progressed (Group 2) or not (Group 1) by measuring the longest distance between the parietal pleura and the visceral pleura both in the early and late pneumothorax. Additionally, we analyzed the relationship between the progression of pneumothorax after biopsy and 1) the depth of the pulmonary nodule; 2) the number of biopsies; 3) the presence or absence of emphysema at the biopsy site; and 4) the size of the pulmonary nodule. Biopsy was successful in 19 of 22 nodules (86.3%). Of the 19 nodules, 12 (63.2%) were malignant and 7 (36.8%) were benign. Twelve patients (54.5%) were classified as group 1 and 10 patients (45.4%) as group 2. The distance between the lung lesion and pleura showed a statistically significant difference between these two groups: ≤ 1 cm in distance for group 1 (81.8%) and group 2 (18.2%), and > 1 cm in distance for group 1 (30%) and group 2 (70%), ρ 0.05). When early pneumothorax occurs during a biopsy, CT fluoroscopy guided percutaneous needle biopsy is an effective and safe procedure. Aggravation of pneumothorax after biopsy is affected by the depth of the pulmonary nodule

  1. Diagnosis of prostate cancer with needle biopsy: Should all cases ...

    African Journals Online (AJOL)

    Background: The triad of digital rectal examination (DRE), serum prostate specific antigen, and transrectal ultrasound‑guided prostate biopsy is used in the detection of prostate cancer (PCa). It is recommended that all cases of PCa should be diagnosed with needle biopsy before treatment. The exclusion criteria for those ...

  2. PET/CT-guided percutaneous liver mass biopsies and ablations: Targeting accuracy of a single 20 s breath-hold PET acquisition

    International Nuclear Information System (INIS)

    Shyn, P.B.; Tatli, S.; Sahni, V.A.; Sadow, C.A.; Forgione, K.; Mauri, G.; Morrison, P.R.; Catalano, P.J.; Silverman, S.G.

    2014-01-01

    Aim: To determine whether a single 20 s breath-hold positron-emission tomography (PET) acquisition obtained during combined PET/computed tomography (CT)-guided percutaneous liver biopsy or ablation procedures has the potential to target 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG)-avid liver masses as accurately as up to 180 s breath-hold PET acquisitions. Materials and methods: This retrospective study included 10 adult patients with 13 liver masses who underwent FDG PET/CT-guided percutaneous biopsies (n = 5) or ablations (n = 5). PET was acquired as nine sequential 20 s, monitored, same-level breath-hold frames and CT was acquired in one monitored breath-hold. Twenty, 40, 60, and 180 s PET datasets were reconstructed. Two blinded readers marked tumour centres on randomized PET and CT datasets. Three-dimensional spatial localization differences between PET datasets and either 180 s PET or CT were analysed using multiple regression analyses. Statistical tests were two-sided and p < 0.05 was considered significant. Results: Targeting differences between 20 s PET and 180 s PET ranged from 0.7–20.3 mm (mean 5.3 ± 4.4 mm; median 4.3) and were not statistically different from 40 or 60 s PET (p = 0.74 and 0.91, respectively). Targeting differences between 20 s PET and CT ranged from 1.4–36 mm (mean 9.6 ± 7.1 mm; median 8.2 mm) and were not statistically different from 40, 60, or 180 s PET (p = 0.84, 0.77, and 0.35, respectively). Conclusion: Single 20 s breath-hold PET acquisitions from PET/CT-guided percutaneous liver procedures have the potential to target FDG-avid liver masses with equivalent accuracy to 180 s summed, breath-hold PET acquisitions and may facilitate strategies that improve image registration and shorten procedure times

  3. Ultrasound-guided core needle biopsy for breast cancer

    International Nuclear Information System (INIS)

    Naqvi, S.Q.H.; Solangi, R.A.; Memon, M.; Solangi, R.A.

    2008-01-01

    To evaluate the efficacy of ultrasound-guided core needle biopsy (US-CNB) as a preoperative diagnostic modality for breast cancer. Females with solid and/or intermediate breast lesions visualized on ultrasonography. Apart from clinical work-up, all the above mentioned patients underwent ultrasound-guided core needle biopsy and excisional biopsy of their breast lesions. The histopathological diagnosis on ultrasound-guided core needle biopsy was then compared with the findings of the excisional biopsy. Out of the total 93 cases, 47(50.5%) had benign lesions on ultrasound; US-CNB showed 24 as fibroadenomata, four with chronic non-specific mastitis, five chronic suppurative mastitis, one tuberculosis, four fat necrosis, two lactational adenoma and seven cases with benign ductal hyperplasia without atypia. Nine (9.7%) cases showed suspicious abnormality on ultrasound; US-CNB revealed five cases with atypical ductal hyperplasia, one ductal carcinoma in situ and three invasive ductal carcinoma. Thirty seven (39.8%) cases were highly suggestive of malignancy on ultrasound; US-CNB showed 34 as invasive ductal carcinoma, two invasive lobular and one medullary carcinoma. Excisional biopsy confirmed the diagnosis of ultrasound-guided core needle biopsy in all cases except four; one case of chronic suppurative mastitis was diagnosed as that of tuberculosis and three cases of atypial ductal hyperplasia as invasive ductal carcinoma. Hence there was no false positive case, but four (4.3%) false negative cases. The sensitivity of the US-CNB was thus 100% and specificity 91.1%. Ultrasound guided core needle biopsy is a satisfactory procedure for the histopathological diagnosis of breast lesions. Any unsatisfactory, suspicious or atypical change on US-CNB should be followed by an open biopsy. (author)

  4. Dedifferentiated chondrosarcoma: use of MRI to guide needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, A. E-mail: asaifuddin@aol.com; Mann, B.S.; Mahroof, S.; Pringle, J.A.S.; Briggs, T.W.R.; Cannon, S.R

    2004-03-01

    AIM: To describe the use of MRI to identify and biopsy areas of dedifferentiation in patients with a suspected diagnosis of dedifferentiated chondrosarcoma. MATERIALS AND METHODS: Low-grade chondrosarcoma is characterized at magnetic resonance imaging (MRI) as having a lobulate, hyperintense appearance on T2-weighted spin-echo sequences. T2-weighted MR images were assessed in 15 patients with a final pathological diagnosis of dedifferentiated chondrosarcoma for regions of atypical reduced signal intensity. Information regarding the site of ultrasound or computed tomography (CT)-guided biopsy was available in 10 cases. RESULTS: Nine patients were male and six female with a mean age of 60 years (range 25-77 years). The sites involved were the distal femur (n=4), pelvis (n=3), proximal femur (n=4), femoral diaphysis (n=1), proximal humerus (n=2) and proximal tibia (n=1). The dedifferentiated component consisted of osteosarcoma (n=5), malignant fibrous histiocytoma (n=6), spindle cell sarcoma (n=1), leiomyosarcoma (n=1) and pleomorphic sarcoma (n=1). In 14 of the 15 cases, areas of lower signal intensity lacking in lobulation were identified. In nine of the 10 cases, biopsy site included such areas and yielded high-grade sarcoma. CONCLUSIONS: Dedifferentiation within chondrosarcoma may be identified on T2-weighted MRI as areas of reduced signal intensity. These areas should be the preferred site of biopsy.

  5. Effect of needle tract bleeding on occurrence of pneumothorax after transthoracic needle biopsy

    International Nuclear Information System (INIS)

    Topal, U.; Berkman, Yahya M.

    2005-01-01

    Purpose: Occasionally bleeding along the needle trajectory is observed at post-biopsy computed tomographic sections. This study was designed to evaluate the possible effect of needle tract bleeding on the occurrence of pneumothorax and on requirement of chest tube insertion. Materials and methods: Two hundred eighty-four needle biopsies performed in 275 patients in whom the needle traversed the aerated lung parenchyma were retrospectively reviewed. Bleeding along the needle tract, occurrence of pneumothorax and need for chest tube insertion, type and size of the needle, size of the lesion, length of the lung traversed by the needle, presence or absence of emphysema were noted. Effect of these factors on the rate of pneumothorax and needle-tract bleeding was evaluated. The data were analyzed by χ 2 test. Results: Pneumothorax developed in 100 (35%) out of 284 procedures requiring chest tube placement in 16 (16%). Variables that were significantly associated with an increased risk of pneumothorax were depth of the lesion (P 0.05). However, analysis of the relation between length of lung traversed by the needle, tract-bleeding and pneumothorax rate indicated that tract-bleeding had a preventive effect on development of pneumothorax (P 0.05). Conclusion: Bleeding in the needle tract has a preventive effect on the occurrence of the pneumothorax in deep-seated lesions and in the presence of emphysema, although it does not affect the overall rate of pneumothorax

  6. Is percutaneous fine-needle biopsy a hazard? An update

    International Nuclear Information System (INIS)

    Smith, E.H.

    1987-01-01

    Fine-needle biopsy (FNB) has become a commonplace diagnostic procedure in most radiology departments with the assumption that risks are nonexistent. Animal experiments conclusively indicate the leakage of tumor cells after biopsy, but clinical evidence appears to point to a paucity of complications. In a prior review of the literature, two needle tract seedings (NTS) and two fatalities after FNB were discovered. A questionnaire at that time uncovered three more cases of NTS and four deaths. An updated literature search and questionnaire showed an additional 14 cases of NTS and nine deaths. An analysis of the date are reported

  7. Ultrasound guided needle biopsy of skeletal muscle in neuromuscular disease

    DEFF Research Database (Denmark)

    Lindequist, S; Schrøder, H D; Larsen, C

    1990-01-01

    Guided by ultrasonography percutaneous needle biopsy of skeletal muscle was performed in 24 patients, using the one hand held Biopty system and a 2 mm Tru-Cut needle. The specimens were graded with regard to diagnostic quality and utility and almost all specimens (96%) were of highest quality. Th....... The use of ultrasonography was helpful in selecting a suitable area for the biopsy and vascular structures could be avoided. The procedure was well tolerated and easy to perform, and no complications were recorded....

  8. Transjugular liver biopsy : the efficacy of quick-core biopsy needle system

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Gyoo Sik; Ahn, Byung Kwon; Lee, Sang Ouk; Chang, Hee Kyong; Oh, Kyung Seung; Huh, Jin Do; Joh, Young Duk [Kosin Medical College, Pusan (Korea, Republic of)

    1998-02-01

    To evaluate the efficacy of the Quick-Core biopsy needle system in performing transjugular liver biopsy. Between December 1995 and June 1997, eight patients underwent transjugular liver biopsy involving use of the Quick-Core biopsy needle system; the conditions involved were coagulopathy (n=4), thrombocytopenia (n=3), and ascites (n=1). Via the right internal jugular vein, the right hepatic vein was selectively catheterized with a 7-F transjugular guiding catheter, and a14-guage stiffening cannula was then inserted through this catheter; to obtain core tissue, a Quick-Core needle was then advanced into the liver parenchyma through the catheter-cannula combination. Eighteen- and 19-guage needles were used in three and five patients, respectively; specimen size, adequacy of the biopsy specimen and histologic diagnosis were determined, and complications were recorded. Biopsy was successful in all patients. The mean length of the specimen was 1.4 cm (1.0 - 1.8 cm), and all were adequate for pathologic examinations ; specific diagnosis was determined in all patients. There were two malignant neoplasms, two cases of veno-occlusive disease, and one case each of cirrhosis, fulminant hepatitis, Banti syndrome and Budd-Chiari syndrome. One patient complained of neck pain after the procedure, but no serious procedural complications were noted. Our preliminary study shows that the Quick-Core biopsy needle system is safe and provides adequate core tissues with high diagnostic yields. (author). 23 refs., 1 tab., 3 figs.

  9. Transjugular liver biopsy : the efficacy of quick-core biopsy needle system

    International Nuclear Information System (INIS)

    Jung, Gyoo Sik; Ahn, Byung Kwon; Lee, Sang Ouk; Chang, Hee Kyong; Oh, Kyung Seung; Huh, Jin Do; Joh, Young Duk

    1998-01-01

    To evaluate the efficacy of the Quick-Core biopsy needle system in performing transjugular liver biopsy. Between December 1995 and June 1997, eight patients underwent transjugular liver biopsy involving use of the Quick-Core biopsy needle system; the conditions involved were coagulopathy (n=4), thrombocytopenia (n=3), and ascites (n=1). Via the right internal jugular vein, the right hepatic vein was selectively catheterized with a 7-F transjugular guiding catheter, and a14-guage stiffening cannula was then inserted through this catheter; to obtain core tissue, a Quick-Core needle was then advanced into the liver parenchyma through the catheter-cannula combination. Eighteen- and 19-guage needles were used in three and five patients, respectively; specimen size, adequacy of the biopsy specimen and histologic diagnosis were determined, and complications were recorded. Biopsy was successful in all patients. The mean length of the specimen was 1.4 cm (1.0 - 1.8 cm), and all were adequate for pathologic examinations ; specific diagnosis was determined in all patients. There were two malignant neoplasms, two cases of veno-occlusive disease, and one case each of cirrhosis, fulminant hepatitis, Banti syndrome and Budd-Chiari syndrome. One patient complained of neck pain after the procedure, but no serious procedural complications were noted. Our preliminary study shows that the Quick-Core biopsy needle system is safe and provides adequate core tissues with high diagnostic yields. (author). 23 refs., 1 tab., 3 figs

  10. Computed tomography - guided cutting needle biopsy of pulmonary lesions

    International Nuclear Information System (INIS)

    Liao Shin Yu; Deheinzelin, Daniel; Younes, Riad N.; Chojniak, Rubens

    2002-01-01

    The purpose of this study was to report the experience of a radiology department in the use of computed tomography-guided cutting needle biopsy of pulmonary nodules, by evaluating diagnostic yield and incidence of complications. This is a retrospective analysis of 52 consecutive patients who underwent lung lesion biopsy guided by computed tomography, performed between May 1997 and May 2000. Thirty-five patients were male and 17 were female, with ages ranging from 5 to 85 years (median, 62 years). The size of the lesions ranged from 1.8 to 15 cm (median, 5.4 cm). In a total of 52 biopsies of lung lesions, 51 biopsies (98.1%) supplied appropriate material for histopathological diagnosis, with 9 diagnosed (17.3%) as benign and 42 (80.8%) as malignant lesions. Specific diagnosis was obtained in 44 (84.6%) biopsies: 4 benign (9.1%) and 40 (90.9%) malignant lesions. The sensitivity, specificity, and accuracy of the cutting needle biopsies for determining presence of malignancy were 96.8%, 100%, and 97.2%, respectively. Complications occurred in 9 cases (17.3%), including 6 cases (11.5%) of small pneumothorax, 1 (1.9%) of hemoptysis, 1 (1.9%) of pulmonary hematoma, and 1 (1.9%) of thoracic wall hematoma. All had spontaneous resolution. There were no complications requiring subsequent intervention. The high sensitivity and specificity of the method and the low rate of complications have established cutting needle biopsy as an efficient and safe tool for the diagnosis of lung lesions. In our hospital, cutting needle biopsy is considered a reliable procedure for the evaluation of indeterminate pulmonary nodules. (author)

  11. Pathologic fracture through a unicameral bone cyst of the pelvis: CT-guided percutaneous curettage, biopsy, and bone matrix injection.

    Science.gov (United States)

    Tynan, Jennifer R; Schachar, Norman S; Marshall, Geoffrey B; Gray, Robin R

    2005-02-01

    Unicameral bone cysts of the pelvis are extremely rare. A 19-year old man presented with a pathologic fracture through a pelvic unicameral bone cyst. He was treated with computed tomography-guided percutaneous curettage, biopsy, and demineralized bone matrix injection. Treatment has proven successful in short-term follow-up.

  12. Biopsy Needle Localization and Tracking Using ROI-RK Method

    Directory of Open Access Journals (Sweden)

    Yue Zhao

    2014-01-01

    Full Text Available ROI-RK method is a biopsy needle localization and tracking method. Previous research work has proved that it has a robust performance on different series of simulated 3D US volumes. Unfortunately, in real situations, because of the strong speckle noise of the ultrasound image and the different echogenic properties of the tissues, the real 3D US volumes have more complex background than the simulated images used previously. In this paper, to adapt the ROI-RK method in real 3D US volumes, a line-filter enhancement calculation only in the ROI is added to increase the contrast between the needle and background tissue, decreasing the phenomenon of expansion of the biopsy needle due to reverberation of ultrasound in the needle. To make the ROI-RK method more stable, a self-correction system is also implemented. Real data have been acquired on an ex vivo heart of lamb. The result of the ROI-RK method shows that it is capable to localize and track the biopsy needle in real situations, and it satisfies the demand of real-time application.

  13. Percutaneous core needle biopsies: The yield in spinal tuberculosis

    African Journals Online (AJOL)

    2014-01-29

    Jan 29, 2014 ... abscess formation, which was epidural in 8 and prevertebral in 13. One patient ... To (i) assess the yield of percutaneous needle biopsies; (ii) identify factors that may lead to a negative result; and (iii) determine .... ultimately detected, not testing for drug susceptibility risks a delay of .... Int J Tuberc Lung Dis.

  14. Morphea on the Breast after a Needle Biopsy

    OpenAIRE

    Arase, Noriko; Igawa, Ken; Senda, Satoko; Terao, Mika; Murota, Hiroyuki; Katayama, Ichiro

    2011-01-01

    Localized scleroderma (morphea) usually develops spontaneously, but the precise mechanisms underlying disease development are obscure. However, a significant number of cases suggest that morphea is induced by external stimuli. Herein, we report a case of morphea that developed after a needle biopsy.

  15. Thin-needle aspiration biopsy of the prostate.

    Science.gov (United States)

    Koss, L G; Woyke, S; Schreiber, K; Kohlberg, W; Freed, S Z

    1984-05-01

    The authors summarize the current status of thin-needle aspiration biopsy of the prostate and evaluate the accomplishments and limitations of this method of diagnosis. Historical developments, indications, technique, contraindications, complications, cytology of aspirates, diagnostic efficacy of aspirates, and grading of prostatic carcinomas are discussed.

  16. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications.

  17. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    International Nuclear Information System (INIS)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu

    2017-01-01

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications

  18. Clinical experience of quantex coordinate software for CT guided stereotactic surgery

    International Nuclear Information System (INIS)

    Yabashi, Toshitake; Ichikawa, Hideo; Yasuda, Eisuke; Tsuruta, Hatsuo; Ishikawa, Yoshihisa; Kimura, Tokuji; Kanamori, Isao

    1991-01-01

    Recently, Quantex Coordinate Software was newly developed for CT-guided stereotactic surgery. We have the opportunity of using this software in 6 cases with intracerebral hematoma for evacuation and 2 cases with brain tumor for needle biopsy by using CT-guided stereotactic surgery. The followings are the features with a little clinical experience. One of the biggest features is that this software can simulate the best expected route of the puncture needle from burr hole to target point before inserting. Also compared with CT 9000 series Software, it has many new functions for more advanced hardware as well as advance standard software. Two cases of intracerebral hematoma for evacuation and 1 case of a brain tumor for a biopsy were carried out using this software mainly as a simulation. In all cases, this software proved to be very useful. (author)

  19. False-negative results of breast core needle biopsies – retrospective analysis of 988 biopsies

    International Nuclear Information System (INIS)

    Boba, Marek; Kołtun, Urszula; Bobek-Billewicz, Barbara; Chmielik, Ewa; Eksner, Bartosz; Olejnik, Tomasz

    2011-01-01

    Breast cancer is the most common malignant neoplasm and the most common cause of death among women. The core needle biopsy is becoming a universal practice in diagnosing breast lesions suspected of malignancy. Unfortunately, breast core needle biopsies also bear the risk of having false-negative results. 988 core needle breast biopsies were performed at the Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, between 01 March 2006 and 29 February 2008. Malignant lesions were diagnosed in 426/988 (43.12%) cases, atypical hyperplasia in 69/988 (6.98%), and benign lesions in 493/988 (49.90%) cases. Twenty-two out of 988 biopsies (2.23%) were found to be false negative. Histopathological assessment of tissue specimens was repeated in these cases. In 14/22 (64%) cases, the previous diagnosis of a benign lesion was changed. In 8/22 (36%) cases, the diagnosis of a benign lesion was confirmed. False-negative rate was calculated at 2.2%. The rate of false-negative diagnoses resulting from a radiological mistake was estimated at 36%. The rate of false-negative diagnoses, resulting from histopathological assessment, was 64%. False-negative results caused by a radiological error comprised 1.5% of all histopathologically diagnosed cancers and atypias (sensitivity of 98.5%). There were no false-positive results in our material - the specificity of the method was 100%. Histopathological interpretation is a substantial cause of false-negative results of breast core needle biopsy. Thus, in case of a radiological-histopathological divergence, histopathological analysis of biopsy specimens should be repeated. The main radiological causes of false-negative results of breast core needle biopsy are as follows: sampling from an inappropriate site and histopathological non-homogeneity of cancer infiltration

  20. False-negative results of breast core needle biopsies - retrospective analysis of 988 biopsies

    International Nuclear Information System (INIS)

    Boba, M.; Koltun, U.; Bobek-Billewicz, B.; Eksner, B.; Olejnik, T.; Chmielik, E.

    2011-01-01

    Background: Breast cancer is the most common malignant neoplasm and the most common cause of death among women. The core needle biopsy is becoming a universal practice in diagnosing breast lesions suspected of malignancy. Unfortunately, breast core needle biopsies also bear the risk of having false-negative results. Material/Methods: 988 core needle breast biopsies were performed at the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, between 01 March 2006 and 29 February 2008. Malignant lesions were diagnosed in 426/988 (43.12%) cases, atypical hyperplasia in 69/988 (6.98%), and benign lesions in 493/988 (49.90%) cases. Results: Twenty-two out of 988 biopsies (2.23%) were found to be false negative. Histopathological assessment of tissue specimens was repeated in these cases. In 14/22 (64%) cases, the previous diagnosis of a benign lesion was changed. In 8/22 (36%) cases, the diagnosis of a benign lesion was confirmed. False-negative rate was calculated at 2.2%. The rate of false-negative diagnoses resulting from a radiological mistake was estimated at 36%. The rate of false-negative diagnoses, resulting from histopathological assessment, was 64%. False-negative results caused by a radiological error comprised 1.5% of all histopathologically diagnosed cancers and atypias (sensitivity of 98.5%). There were no false-positive results in our material - the specificity of the method was 100%. Conclusions: Histopathological interpretation is a substantial cause of false-negative results of breast core needle biopsy. Thus, in case of a radiological-histopathological divergence, histopathological analysis of biopsy specimens should be repeated. The main radiological causes of false-negative results of breast core needle biopsy are as follows: sampling from an inappropriate site and histopathological non-homogeneity of cancer infiltration. (authors)

  1. Percutaneous needle-biopsy of the adrenal glands

    International Nuclear Information System (INIS)

    Wernecke, K.; Galanski, M.

    1986-01-01

    This account of techniques, range of indications and results of percutaneous adrenal biopsy refers to communications in the literature and to the authors' own experience. Lateral, transhepatic aspiration of adrenal material guided by sonographic control is more easy in the right adrenal gland. Punctation of the left adrenal gland ought to be done from the back and guided by computerized tomography, also in order to leave spleen, kidney, pancreas and stomach as unaffected as possible. The most frequent problem indicating adrenal biopsy still is differentiation between metastases or encretorily non-active adenomas in tumor patients. Experienced examiners will achieve an 80 to 90% sensitivity of adrenal biopsy. Clinically established, suspected phaeochromocytoma is an absolute contra-indication to fine-needle biopsy. (orig./MG) [de

  2. Tumour seeding following percutaneous needle biopsy: The real story

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, E.G. [Department of Radiology, Western Infirmary, Glasgow (United Kingdom); Baxter, G., E-mail: grant.baxter@ggc.scot.nhs.uk [Department of Radiology, Western Infirmary, Glasgow (United Kingdom)

    2011-11-15

    The demand for percutaneous needle biopsy is greater than ever before and with the majority of procedures requiring imaging guidance, radiologists have an increasingly important role in the diagnostic work-up of patients with suspected malignancy. All invasive procedures incur potential risks; therefore, clinicians should be aware of the most frequently encountered complications and have a realistic idea of their likelihood. Tumour seeding, whereby malignant cells are deposited along the tract of a biopsy needle, can have disastrous consequences particularly in patients who are organ transplant candidates or in those who would otherwise expect good long-term survival. Fortunately, tumour seeding is a rare occurrence, yet the issue invariably receives a high profile and is often regarded as a major contraindication to certain biopsy procedures. Although its existence is in no doubt, realistic insight into its likelihood across the spectrum of biopsy procedures and multiple anatomical sites is required to permit accurate patient counselling and risk stratification. This review provides a comprehensive overview of tumour seeding and examines the likelihood of this much feared complication across the range of commonly performed diagnostic biopsy procedures. Conclusions have been derived from an extensive analysis of the published literature, and a number of key recommendations should assist practitioners in their everyday practice.

  3. Computed tomography-guided needle aspiration and biopsy of pulmonary lesions - A single-center experience in 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Poulou, Loukia S.; Tsagouli, Paraskevi; Thanos, Loukas [Dept. of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases ' Sotiria' , Athens (Greece)], e-mail: ploukia@hotmail.com; Ziakas, Panayiotis D. [Program of Outcomes Research, Div. of Infectious Diseases, Warren Alpert Medical School, Brown Univ., RI, and Div. of Infectious Diseases, Rhode Island Hospital, Rhode Island (United States); Politi, Dimitra [Dept. of Cythopathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece); Trigidou, Rodoula [Dept. of Pathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece)

    2013-07-15

    Background: Computed tomography (CT)-guided fine needle aspiration (FNA) and biopsies are well-established, minimally invasive diagnostic tools for pulmonary lesions. Purpose: To analyze retrospectively the results of 1000 consecutive lung CT-guided FNA and/or core needle biopsies (CNB), the main outcome measures being diagnostic yield, and complication rates. Material and Methods: Patients considered eligible were those referred to our department for lung lesions. The choice of FNA, CNB, or both was based upon the radiologist's judgment. Diagnostic yield was defined as the probability of having a definite result by cytology/histology. Results: The study included 733 male patients and 267 female patients, with a mean (SD) age of 66.4 (11.4) years. The mean (SD) lesion size was 3.7 (2.4) cm in maximal diameter. Six hundred and forty-one (64%) patients underwent an FNA procedure, 245 (25%) a CNB, and 114 (11%) had been subjected to both. The diagnostic yield was 960/994 (96.6%); this decreased significantly with the use of CNB only (odds ratio [OR] 0.32; 95% CI 0.12 - 0.88; P = 0.03), while it increased with lesion size (OR 1.35; 95% CI 1.03 - 1.79; P = 0.03 per cm increase). In 506 patients (52.7%), a malignant process was diagnosed by cytopathology/histology. The complication rate reached 97/1000 (9.7%); complications included: hemorrhage, 62 (6.2%); pneumothorax, 28 (2.8%); hemorrhage and pneumothorax, 5 (0.5%); and hemoptysis, 2 (0.2%). It was not significantly affected by the type of procedure or localization of the lesion. The overall risk for complications was three times higher for lesions <4 cm (OR 3.26; 95% CI 1.96 - 5.42; P < 0.001). Conclusion: CT-guided lung biopsy has a high diagnostic yield using FNA, CNB, or both. The CNB procedure alone will not suffice. Complication rates were acceptable and correlated inversely with lesion size, not localization or type of procedure.

  4. Diagnosis of prostate cancer with needle biopsy: should all cases be biopsied before treatment?

    Science.gov (United States)

    Oranusi, C K; Ugezu, A I; Nwofor, Ame

    2012-01-01

    The triad of digital rectal examination (DRE), serum prostate specific antigen, and transrectal ultrasound-guided prostate biopsy is used in the detection of prostate cancer (PCa). It is recommended that all cases of PCa should be diagnosed with needle biopsy before treatment. The exclusion criteria for those that may not be suitable have not yet been defined. We reviewed all the patients diagnosed with PCa at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Southeast, Nigeria, from January 2007 to December 2010. Relevant biodata and method of diagnosis of PCa before treatment were reviewed. A total of 133 patients had bilateral orchidectomy over the period. 120 (90.2%) had their diagnosis confirmed by needle biopsy before bilateral orchidectomy (category 1), while 13 (9.8%) had bilateral orchidectomy before diagnosis was confirmed. The method of diagnosis for category 1 patients was with lower urinary tract symptoms (LUTS), abnormal DRE findings, elevated prostate-specific antigen (PSA), and transrectal needle biopsy. For category 11 patients, diagnosis of PCa was suspected based on LUTS, abnormal DRE findings, and elevated PSA. Of this number, 11 (84.6%) had, in addition, sudden onset paraplegia at presentation, while 2 (15.4%) had severe uncontrolled hematuria at presentation. All the patients in both categories had needle biopsy confirmation of their disease. The sensitivity of PSA was 99.2%. Needle biopsy of the prostate is the preferred method for the diagnosis of PCa in most cases before treatment is undertaken. There are valid reasons why all PCas will not be diagnosed in this fashion. Elevated PSA when combined with an abnormal DRE finding increases the predictive value for cancer. In areas where pathologists are lacking, abnormal DRE and elevated PSA results can be a guide to proceed to treatment especially, where there is severe compromise of patients' quality of life due to symptoms of advanced PCa while awaiting confirmation.

  5. CT-guided percutaneous lung biopsy: Comparison of conventional CT fluoroscopy to CT fluoroscopy with electromagnetic navigation system in 60 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Grand, David Justin, E-mail: dgrand@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Atalay, Michael A., E-mail: matalay@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Cronan, John J., E-mail: cronan@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Mayo-Smith, William W., E-mail: wmayo-smith@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States); Dupuy, Damian E., E-mail: ddupuy@lifespan.org [Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, Providence, RI 02903 (United States)

    2011-08-15

    Purpose: To determine if use of an electromagnetic navigation system (EMN) decreases radiation dose and procedure time of CT fluoroscopy guided lung biopsy in lesions smaller than 2.5 cm. Materials/methods: 86 consecutive patients with small lung masses (<2.5 cm) were approached. 60 consented and were randomized to undergo biopsy with CT fluoroscopy (CTF) (34 patients) or EMN (26 patients). Technical failure required conversion to CTF in 8/26 EMN patients; 18 patients completed biopsy with EMN. Numerous biopsy parameters were compared as described below. Results: Average fluoroscopy time using CTF was 28.2 s compared to 35.0 s for EMN (p = 0.1). Average radiation dose was 117 mGy using CTF and 123 mGy for EMN (p = 0.7). Average number of needle repositions was 3.7 for CTF and 4.4 for EMN (p = 0.4). Average procedure time was 15 min for CTF and 20 min for EMN (p = 0.01). There were 7 pneumothoracesin the CTF group and 6 pneumothoraces in the EMN group (p = 0.7). One pneumothorax in the CTF group and 3 pneumothoraces in the EMN group required chest tube placement (p = 0.1). One pneumothorax patient in each group required hospital admission. Diagnostic specimens were obtained in 31/34 patients in the CTF group and 22/26 patients in the EMN group (p = 0.4). Conclusions: EMN was not statistically different than CTF for fluoroscopy time, radiation dose, number of needle repositions, incidence of pneumothorax, need for chest tube, or diagnostic yield. Procedure time was increased with EMN.

  6. Utility of CT-guided abdominal aspiration procedures

    International Nuclear Information System (INIS)

    Sundaram, M.; Wolverson, M.K.; Heiberg, E.; Pilla, T.; Vas, W.G.; Shields, J.B.

    1982-01-01

    Over 200 consecutive diagnostic needle aspiration procedures of the abdomen were performed under computed tomographic (CT) guidance. Biopsies were done of the liver in 88 patients, the pancreas in 28, the kidney in 20, and the retroperitoneum in 32; 30 underwent an aspiration procedure for characterization of an intraabdominal fluid collection. Accuracy of diagnosis was very high for hepatic (99%) and renal (100%) biopsies and in characterization of fluid collections (100%). Accuracy for retroperitoneal biopsy was 87.5% and for pancreatic biopsy 82%. Overall accuracy for all sites was 95%. There were one false-negative diagnosis for the liver and five false-negative diagnoses for the pancreas. Insufficient material was obtained for diagnosis in four instances of retroperitoneal biopsy. There were no false positives. The technique is facilitated by rapid CT scan time, large aperture gantry, and rapid CT image reconstruction. Twenty gauge needles were used more frequently than 22 gauge needles because of their greater rigidity and ease of control. CT-guided diagnostic aspiration procedures are particularly useful for diagnosis of small, deep-seated lesions and in evaluation of lesions found in severely ill patients. An experienced cytologist is essential to the success of the technique

  7. Effect of Needle Size in Ultrasound-guided Core Needle Breast Biopsy: Comparison of 14-, 16-, and 18-Gauge Needles.

    Science.gov (United States)

    Giuliani, Michela; Rinaldi, Pierluigi; Rella, Rossella; Fabrizi, Gina; Petta, Federica; Carlino, Giorgio; Di Leone, Alba; Mulè, Antonino; Bufi, Enida; Romani, Maurizio; Belli, Paolo; Bonomo, Lorenzo

    2017-11-01

    The aim of the present study was to assess the diagnostic accuracy of ultrasound-guided core needle biopsy (US-CNB) of breast lesions, comparing smaller needles (16- and 18-gauge) with the 14-gauge needle, and to analyze the lesion characteristics influencing US-CNB diagnostic performance. All the patients provided informed consent before the biopsy procedure. The data from breast lesions that had undergone US-CNB in our institution from January 2011 to January 2015 were retrospectively reviewed. The inclusion criterion was the surgical histopathologic examination findings of the entire lesion or radiologic follow-up data for ≥ 24 months. The exclusion criterion was the use of preoperative neoadjuvant therapy. The US-CNB results were compared with the surgical pathologic results or with the follow-up findings in the 3 needle size groups (14-, 16-, and 18-gauge). The needle size- and lesion characteristic-specific diagnostic accuracy parameters were evaluated. Statistical analysis was performed using a dedicated software program, and P ≤ .01 was considered significant. A total of 1118 US-CNB cases (1042 patients) were included. Of the 1118 cases, 630 (56.3%) were in the 14-gauge group, 136 (12.2%) in the 16-gauge, and 352 (31.5%) in the 18-gauge needle group. Surgery was performed on 800 lesions (71.6%). Of these, 619 were malignant, 77 were high risk, and 104 were benign. The remaining 318 lesions (28.4%) underwent follow-up imaging studies. All the lesions were stable and, therefore, were considered benign. No differences were observed in the diagnostic accuracy parameters among the 3 needle size groups (P > .01). The false-negative rate was greater for lesions  .01). US-CNB performed with small needles (16 and 18 gauge) had the same diagnostic accuracy as that performed with 14-gauge needles, regardless of the lesion characteristics. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Yield of abrams needle pleural biopsy in exudative pleural effusion

    International Nuclear Information System (INIS)

    Khan, I.N.; Zaman, M.; Khan, N.; Jadoon, H.; Ahmed, A.

    2009-01-01

    Pleural effusion is the abnormal collection of fluid in the pleural space resulting from excessive fluid production or decreased absorption and it is one of the most common clinical conditions that we come across in pulmonology clinics and in hospitals. The objective of prospective study was to evaluate the diagnostic role of Abrams Needle Biopsy in Exudative Pleural Effusion The study was performed at the Department of Pulmonology, Ayub Teaching Hospital, Abbottabad over a period of 1 year, i.e., January 2008 to December 2008. Sixty-three patients of either sex and all ages with exudative pleural effusion, on whom Abrams Needle Biopsy was performed were included in the study. Minimum of four specimens from each patient were taken and histopathology done. Out of 63 patients, histopathology revealed the cause in 60 (95%) cases. Tuberculosis, malignancy and rheumatoid pleurisy were confirmed in 34, 24, and 2 cases respectively. Specimens of 3 patients did not reveal any result and showed non-specific inflammation and were further investigated accordingly. The diagnostic yield of Biopsy was 95%. Pleural biopsy is still a reliable and valuable investigation in diagnosing pleural effusion, provided that adequate pleural specimen is taken. (author)

  9. CT-guided stereotactic neurosurgery

    International Nuclear Information System (INIS)

    Takizawa, Takaaki; Sato, Shoju; Matsumoto, Akira; Sano, Akira; Takahashi, Kazunori; Murakami, Yuji; Ohta, Kosuke

    1985-01-01

    Brown-Roberts-Wells stereotactic instruments were used for CT guided stereotactic surgery in 54 cases (65 operations). Stereotactic biopsy was done in 9 cases and successive regional chemotherapy was done in 3 cases. Stereotactic drainage was done in 2 cases of bacterial abcess, 3 cases of cystic neoplasm and 33 cases (43 operations) of intracerebral hematoma. CT guided stereotactic procedure was valuable for the correct cannulation to the center of the cavity. We tried to utilize CT image for the selection of targets for stereotactic functional neurosurgical procedures in 6 cases. In the cases of thalamotomy, the information derived from CT made the operation safer than that by contrast ventriculography alone. In all cases of electrode implantation for deep brain stimulation, accurate and precise electrode placement was achieved from CT images alone. This rapid and easy surgical technique was useful also for poor risk patients. (author)

  10. Ga-68 DOTATOC PET/CT-Guided Biopsy and Cryoablation with Autoradiography of Biopsy Specimen for Treatment of Tumor-Induced Osteomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Maybody, Majid, E-mail: maybodym@mskcc.org [Memorial Sloan Kettering Cancer Center, Interventional Radiology Service (United States); Grewal, Ravinder K. [Memorial Sloan Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Healey, John H. [Memorial Sloan Kettering Cancer Center, Orthopedic Surgical Oncology Service, Department of Surgery (United States); Antonescu, Cristina R. [Memorial Sloan Kettering Cancer Center, Department of Pathology (United States); Fanchon, Louise [Memorial Sloan Kettering Cancer Center, Department of Physics (United States); Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States); Carrasquillo, Jorge A. [Memorial Sloan Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Kirov, Assen [Memorial Sloan Kettering Cancer Center, Department of Physics (United States); Farooki, Azeez [Memorial Sloan Kettering Cancer Center, Department of Medicine (United States)

    2016-09-15

    Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by small benign tumors of mesenchymal origin also known as phosphaturic mesenchymal tumors mixed connective tissue variant. Excellent prognosis is expected with eradication of the culprit tumor. These small tumors are notoriously difficult to localize with conventional imaging studies; this often leads to an extensive work up and prolonged morbidity. We report a patient with clinical diagnosis of TIO whose culprit tumor was localized with Ga-68 DOTATOC PET/CT and MRI. Biopsy and cryoablation were performed under Ga-68 DOTATOC PET/CT guidance. Autoradiography of the biopsy specimen was performed and showed in situ correlation between Ga-68 DOTATOC uptake and histopathology with millimeter resolution.

  11. Percutaneous image-guided needle biopsy in children - summary of our experience with 57 children

    International Nuclear Information System (INIS)

    Sklair-Levy, M.; Lebensart, P.D.; Applbaum, Y.H.; Bar-Ziv, J.; Libson, E.; Ramu, N.; Freeman, A.; Gozal, D.; Gross, E.; Sherman, Y.

    2001-01-01

    Background: Percutaneous image-guided needle biopsy in children has been slower to gain acceptance than in adults where it is regarded as the standard clinical practice in screening suspicious masses. Objectives: To report our experience with percutaneous image-guided needle biopsy in the pediatric population and assess its clinical use, efficacy and limitations. Material and methods: Sixty-nine percutaneous image-guided needle biopsies were performed in 57 children. The age of the children ranged from 4 days to 14 years (mean 5.6 years). We used 16- to-20-gauge cutting-edge needles. Sixty-two biopsies were core-needle biopsies and 7 fine-needle aspiration biopsies. Results: There were 50 malignant lesions, 10 benign lesions and 2 infectious lesions. In 55 (88.7 %) lesions the needle biopsy was diagnostic. In 7 (11.3 %) the biopsy was non-diagnostic and the diagnosis was made by surgery. Core-needle biopsy was diagnostic in 47 of 50 (94 %) of the malignant solid tumors. In 3 out of 5 children with lymphoma, an accurate diagnosis was obtained with needle aspiration. Seven children underwent a repeated core-needle biopsy, (5 for Wilms' tumor and 2 for neuroblastoma) that was diagnostic in all cases. All the biopsies were performed without complications. Conclusion: Percutaneous image-guided needle biopsy is a simple, minimally invasive, safe and accurate method for the evaluation of children with suspicious masses. These data suggest that image-guided needle biopsy is an excellent tool for diagnosing solid tumors in the pediatric population. Negative studies should be considered nondiagnostic and followed by excisional surgical biopsies when clinical suspicion of malignancy is high. (orig.)

  12. Free thyroxine in needle washout after fine needle aspiration biopsy of toxic thyroid nodules.

    Science.gov (United States)

    Raikov, Nikolai; Nonchev, Boyan; Chaushev, Borislav; Vjagova, Diyana; Todorov, Svetoslav; Bocheva, Yana; Malceva, Daniela; Vicheva, Snejinka; Raikova, Asyia; Argatska, Antoaneta; Raikov, Miroslav

    2016-01-01

    The main diagnostic tool for toxic adenomas (TA) is radionuclide imaging indicated in patients with evidence of thyroid nodules in combination with thyrotoxic syndrome. Thyroid ultrasound and fine-needle aspiration biopsy (FNAB) are widely used for the valuation of thyroid masses. There is no literature data concerning the utility of FNAB and related tests for the diagnosis of hyperfunctioning thyroid nodules. The purpose of this study is to determine the levels of free thyroxine (FT4) in the needle washout after FNAB of hot thyroid nodules. The results of our study show that the FT4 levels in needle washout from TA were significantly higher than the surrounding parenchyma and correlated with the hormonal changes in patients with thyroid hyperfunctioning nodules. Further studies on a large number of patients are needed to refine the diagnostic value of this method and evaluate its importance in quantitative risk assessment of thyroid autonomy.

  13. Feasibility of computed tomography-guided core needle biopsy in producing state-of-the-art clinical management in Chinese lung cancer.

    Science.gov (United States)

    Chen, Hua-Jun; Yang, Jin-Ji; Fang, Liang-Yi; Huang, Min-Min; Yan, Hong-Hong; Zhang, Xu-Chao; Xu, Chong-Rui; Wu, Yi-Long

    2014-03-01

    A satisfactory biopsy determines the state-of-the-art management of lung cancer in this era of personalized medicine. This study aimed to investigate the suitability and efficacy of computed tomography (CT)-guided core needle biopsy in clinical management. A cohort of 353 patients with clinically suspected lung cancer was enrolled in the study. Patient factors and biopsy variables were recorded. Epidermal growth factor receptor (EGFR) gene mutations and echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) rearrangement were detected in tumor specimens. Adequacy of biopsic obtainment for clinical trial screening and tissue bank establishment were reviewed. Overall diagnostic accuracy of malignancy achieved 98.5%. The median biopsy time of the cohort was 20 minutes. In patients with non-small cell lung cancer (NSCLC), 99.3% (287/289) were diagnosed as specific histologic subtypes, and two patients (0.7%) were determined as NSCLC not otherwise specified (NOS). EGFR mutations were analyzed in 81.7% (236/289) of patients with NSCLC, and 98.7% (233/236) showed conclusive results. EML4-ALK gene fusion was tested in 43.9% (127/289) of NSCLC patients, and 98.4% (125/127) showed conclusive results: 6.4% (8/125) of those had gene fusion. Ninety-six NSCLC patients participated in clinical trial screening and provided mandatory tumor slides for molecular profiling. Pathological evaluation was fulfilled in 90 patients (93.8%); 99.4% (320/322) of patients with malignancy provided extra tissue for the establishment of a tumor bank. CT-guided core needle biopsy provided optimal clinical management in this era of translational medicine. The biopsic modality should be prioritized in selected lung cancer patients.

  14. EUS – Fine- Needle Aspiration Biopsy (FNAB in the Diagnosis of Pancreatic Adenocarcinoma: A Review

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-03-01

    Full Text Available Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS is a relatively new technology that employs endoscopy and high-frequency ultrasound (US. EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP brushing, CT-guided biopsies, and transabdominal ultrasound (US have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities

  15. Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

    Science.gov (United States)

    Walfish, P G; Strawbridge, H T; Rosen, I B

    1985-12-01

    To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered.

  16. Quantitative analysis of fine needle aspiration biopsy samples

    International Nuclear Information System (INIS)

    Rajer, M.; Kmet, M.

    2005-01-01

    Background. The fine needle aspiration biopsy (FNAB) is one of the methods used in tumour evaluation. Since a certain number of tumour cells are needed for a complete diagnostic algorithm, we wanted to test how many cells remain in the needle and syringe after routine stains have been made and which factors influence this number. The remaining cells are used in ancillary diagnostic procedures. Materials and methods. One hundred fifty two FNAB samples of tumours of the breast, thyroid and lymph nodes were included in our study. We counted the cells which were left in the needle and the syringe after the standard smears had been made. Buerker-Tuerk's chamber was used for this purpose. Results. The number of cells depended on the organ from which the cells had been aspirated, on the type of tumour and, in the case of breast cancer, also on the level of experience of the FNAB performer. The percentage of samples with too few cells for all modern diagnostic methods (<5x105 ) is lowest in FNAB of lymph nodes (4.9%), followed by breast (16.7%) and thyroid (18%). Conclusions. We concluded that FNAB in the majority of cases grants a sufficient number of cells for the standard microscopic evaluation and also ancillary diagnostic procedures. (author)

  17. Development of the robot system to assist CT-guided brain surgery

    International Nuclear Information System (INIS)

    Koyama, H.; Funakubo, H.; Komeda, T.; Uchida, T.; Takakura, K.

    1999-01-01

    The robot technology was introduced into the stereotactic neurosurgery for application to biopsy, blind surgery, and functional neurosurgery. The authors have developed a newly designed the robot system to assist CT-guided brain surgery, designed to allow a biopsy needle to reach the targget such as a cerebral tumor within a brain automatically on the basis of the X,Y, and Z coordinates obtained by CT scanner. In this paper we describe construction of the robot, the control of the robot by CT image, robot simulation, and investigated a phantom experiment using CT image. (author)

  18. CT-guided radiofrequency ablation of spinal osteoid osteomas with concomitant perineural and epidural irrigation for neuroprotection

    International Nuclear Information System (INIS)

    Klass, Darren; Marshall, Tom; Toms, Andoni

    2009-01-01

    Here we report our experience of a neuroprotective adaptation of the technique of CT-guided radiofrequency (RF) ablation of spinal osteoid osteomas. Over 9 years seven patients underwent eight CT-guided RF treatments for osteoid osteoma. CT-guided RF ablation was performed with general anaesthesia. The lesion was heated to 90 C for 2 min for two cycles by using a Cosman SMK TC-10 RF electrode. This was preceded by a bolus of room temperature sterile water (10 ml) injected through a 26G curved spinal needle into the exit foramen and adjacent epidural space for neuroprotection. The age of the patient, sex, lesion location, biopsy results and complications were recorded. All the biopsies (n = 7) demonstrated histological features of osteoid osteoma. All the procedures were technically successful. Clinical success was assessed up to 3 years post procedure. There was an 85% clinical success rate (6 of the 7 patients), with recurrence of a lesion at 6 months, necessitating a repeat procedure (successful). CT-guided percutaneous RF ablation of spinal osteoid osteoma preceded by bolus of sterile water, injected through a spinal needle into the exit foramen and adjacent epidural space for neuroprotection, is a safe and effective procedure. (orig.)

  19. Histopathologic Review of Previously Negative Prostatic Core Needle Biopsies following a New Diagnosis of Adenocarcinoma of the Prostate by Core Needle Biopsies: Implications for Quality Assurance Programs

    Directory of Open Access Journals (Sweden)

    Jay Patel

    2008-01-01

    Full Text Available Programs for quality assurance are increasingly important in surgical pathology. Many quality assurance (QA techniques for surgical pathology were adopted from procedures introduced in cytopathology. Surgical pathology specimens have diminished in size such that the majority of diagnostic biopsies of prostatic lesions are now core needle biopsies. These specimens raise issues similar to those of cytology specimens, including concerns regarding adequacy and the representative nature of the biopsy. Due to sample size, some neoplasms may not be diagnosed on initial biopsy, raising concerns regarding false negative results. Cytopathologists have instituted QA procedures including review of all previously negative slides received within five years prior to the new diagnosis of high grade squamous intraepithelial lesion or gynecologic malignancy. No such requirement exists in surgical pathology for review of core biopsies. The Department of Pathology at the University of Utah instituted a QA policy requiring review of prior negative prostatic needle biopsies following a new diagnosis of prostatic adenocarcinoma. We reviewed five years of QA records of prostate needle biopsy review. During this time, nine hundred and fifty-eight core biopsy sets were performed. Two hundred and ninety-five of these contained at least one biopsy with a diagnosis of adenocarcinoma. Two hundred and eight patients had a prior set of prostatic needle biopsies with a diagnosis of adenocarcinoma. The remaining 87 had prior biopsies with either a diagnosis of prostatic intraepithelial neoplasia (23, small atypical acinar proliferation (21 or no evidence of malignancy (43. QA review of these 87 cases revealed two biopsies which revealed foci of adenocarcinoma. Both had been initially diagnosed as no evidence of malignancy. The false negative rate for core biopsy was 0.68%. In an additional twenty-one cases, microscopic foci of atypical small acinar proliferations were found in

  20. Hepatic mitochondrial function analysis using needle liver biopsy samples.

    Directory of Open Access Journals (Sweden)

    Michael J J Chu

    Full Text Available BACKGROUNDS AND AIM: Current assessment of pre-operative liver function relies upon biochemical blood tests and histology but these only indirectly measure liver function. Mitochondrial function (MF analysis allows direct measurement of cellular metabolic function and may provide an additional index of hepatic health. Conventional MF analysis requires substantial tissue samples (>100 mg obtained at open surgery. Here we report a method to assess MF using <3 mg of tissue obtained by a Tru-cut® biopsy needle making it suitable for percutaneous application. METHODS: An 18G Bard® Max-core® biopsy instrument was used to collect samples. The optimal Tru-cut® sample weight, stability in ice-cold University of Wisconsin solution, reproducibility and protocol utility was initially evaluated in Wistar rat livers then confirmed in human samples. MF was measured in saponin-permeabilized samples using high-resolution respirometry. RESULTS: The average mass of a single rat and human liver Tru-cut® biopsy was 5.60±0.30 and 5.16±0.15 mg, respectively (mean; standard error of mean. Two milligram of sample was found the lowest feasible mass for the MF assay. Tissue MF declined after 1 hour of cold storage. Six replicate measurements within rats and humans (n = 6 each showed low coefficient of variation (<10% in measurements of State-III respiration, electron transport chain (ETC capacity and respiratory control ratio (RCR. Ischemic rat and human liver samples consistently showed lower State-III respiration, ETC capacity and RCR, compared to normal perfused liver samples. CONCLUSION: Consistent measurement of liver MF and detection of derangement in a disease state was successfully demonstrated using less than half the tissue from a single Tru-cut® biopsy. Using this technique outpatient assessment of liver MF is now feasible, providing a new assay for the evaluation of hepatic function.

  1. Initial experience with new dedicated needles for laparoscopic ultrasound-guided fine-needle aspiration and histological biopsies

    DEFF Research Database (Denmark)

    Mortensen, M B; Durup, J; Pless, T

    2001-01-01

    BACKGROUND AND STUDY AIMS: Laparoscopic ultrasonography (LUS) is an important imaging modality during laparoscopic staging of intra-abdominal malignancies, but LUS-assisted biopsy is often difficult or impossible. We report a newly developed inbuilt biopsy system for direct LUS-guided fine......-needle aspiration (FNA) and Tru-cut biopsies. PATIENTS AND METHODS: LUS-guided biopsy was performed in 20 patients with upper gastrointestinal tract tumors. The biopsied lesions had either not been previously detected by other imaging modalities or had been inaccessible, or the biopsy sample had been inadequate...... were good or acceptable in 18 patients (90%). Slight needle deviation (material was obtained, but pathological examination was impossible owing...

  2. A needle guidance system for biopsy and therapy using two-dimensional ultrasound

    International Nuclear Information System (INIS)

    Bluvol, Nathan; Sheikh, Allison; Kornecki, Anat; Del Rey Fernandez, David; Downey, Donal; Fenster, Aaron

    2008-01-01

    Image-guided needle biopsies are currently used to provide a definitive diagnosis of breast cancer; however, difficulties in tumor targeting exist as the ultrasound (United States) scan plane and biopsy needle must remain coplanar throughout the procedure to display the actual needle tip position. The additional time associated with aligning and maintaining this coplanar relationship results in increased patient discomfort. Biopsy procedural efficiency is further hindered since needle pathway interpretation is often difficult, especially for needle insertions at large depths that usually require multiple reinsertions. The authors developed a system that would increase the speed and accuracy of current breast biopsy procedures using readily available two-dimensional (2D) US technology. This system is composed of a passive articulated mechanical arm that attaches to a 2D US transducer. The arm is connected to a computer through custom electronics and software, which were developed as an interface for tracking the positioning of the mechanical components in real time. The arm couples to the biopsy needle and provides visual guidance for the physician performing the procedure in the form of a real-time projected needle pathway overlay on an US image of the breast. An agar test phantom, with stainless steel targets interspersed randomly throughout, was used to validate needle trajectory positioning accuracy. The biopsy needle was guided by both the software and hardware components to the targets. The phantom, with the needle inserted and device decoupled, was placed in an x-ray stereotactic mammography (SM) machine. The needle trajectory and bead target locations were determined in three dimensions from the SM images. Results indicated a mean needle trajectory accuracy error of 0.75±0.42 mm. This is adequate to sample lesions that are <2 mm in diameter. Chicken tissue test phantoms were used to compare core needle biopsy procedure times between experienced radiologists

  3. MRI-guided trephine biopsy and fine-needle aspiration in the diagnosis of bone lesions in low-field (0.23 T) MRI system using optical instrument tracking

    International Nuclear Information System (INIS)

    Blanco Sequeiros, Roberto; Klemola, Rauli; Ojala, Risto; Jyrkinen, Lasse; Tervonen, Osmo; Lappi-Blanco, Elisa; Soini, Ylermi

    2002-01-01

    The purpose of this study was to evaluate the feasibility of MRI-guided bone biopsy with optical instrument tracking and evaluate advantage of combined fine-needle aspiration (FNA) with trephine biopsy. Twenty trephine bone biopsies and 13 FNAs were performed under MRI and CT guidance in 14 patients. Informed consent was obtained from all patients. The evaluation of diagnostic accuracy was achieved by comparing the histopathological and cytological diagnosis with current or final diagnosis made during 6-month clinical follow-up. A 0.23-T open MRI scanner with interventional tools (Outlook Proview, Marconi Medical Systems, Cleveland, Ohio) was used. A surface coil was used. For trephine biopsy MRI-compatible bone biopsy set (Daum medical, Schwerin, Germany) was used. The FNA was performed with MRI compatible 20-G needle (Cook, Bloomington, Ind.). The diagnostic accuracy of MRI-guided trephine biopsy was 95%. The FNA sample diagnosis concurred with the histological in 54%. Our results show that MRI guidance in bone biopsies is accurate and safe. It is comparable to CT-guided or open biopsy. The role of combined FNA with bone biopsies remains controversial. (orig.)

  4. Performance of combined clinical mammography and needle biopsy: a nationwide study from Denmark

    DEFF Research Database (Denmark)

    Jensen, Allan; Rank, Fritz; Dyreborg, Uffe

    2006-01-01

    Clinical mammography and needle biopsy are key tools for non-operative assessment of breast lesions. We evaluated the performance of all combined tests undertaken in Denmark in 2000. Clinical mammography and needle biopsy data were collected and linked to final cancer outcome, to determine sensit...... with a suspicious or malignant result indicated a high risk of cancer, and excisional diagnostic biopsy therefore still has an important role to play.......Clinical mammography and needle biopsy are key tools for non-operative assessment of breast lesions. We evaluated the performance of all combined tests undertaken in Denmark in 2000. Clinical mammography and needle biopsy data were collected and linked to final cancer outcome, to determine...

  5. A comparison of ultrasound guided fine needle aspiration cytology and core needle biopsy in evaluation of palpable breast lesions

    International Nuclear Information System (INIS)

    Altaf, H.N.; Farooqui, F.

    2015-01-01

    Objective: To compare ultrasound guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients presenting with palpable breast lumps (PBLs), in terms of sensitivity and specificity, taking final histopathology as gold standard. Methodology: This cross-sectional study was conducted at Holy Family Hospital, Rawalpindi, Pakistan. Ultrasound guided FNAC and CNB were taken of all female patients with PBLs. The results were compared with final histopathology as gold standard. Data analysis was performed using SPSS software and chi-square test. Results: A total of 60 patients were included in the study. The mean age was 33.8 yrs. The sensitivity and specificity of ultrasound guided FNAC were 68.7% and 93.1%, respectively. The sensitivity and specificity of ultrasound guided CNB was 93.7% and 100%. The accuracy of FNAC was 86.2% and that of core needle biopsy was 98.3%. Conclusion: The ultrasound guided core needle biopsy can be used as an initial diagnostic test for the evaluation of all PBLs. Because of high negative predictive value core needle biopsy can replace surgical excision biopsy for benign lesions. (author)

  6. Learning curve of thyroid fine-needle aspiration biopsy.

    Science.gov (United States)

    Penín, Manuel; Martín, M Ángeles; San Millán, Beatriz; García, Juana

    2017-12-01

    Fine-needle aspiration biopsy (FNAB) is the reference procedure for thyroid nodule evaluation. Its main limitation are inadequate samples, which should be less than 20%. To analyze the learning curve of the procedure by comparing the results of a non-experienced endocrinologist (endocrinologist 2) to those of an experienced one (endocrinologist 1). Sixty FNABs were analyzed from February to June 2016. Each endocrinologist made 2punctures of every nodule in a random order. This order and the professional making every puncture were unknown to the pathologist who examined the samples. Endocrinologist 1 had a higher percentage of diagnoses than endocrinologist 2 (82% vs. 72%, P=.015). In the first 20 FNABs, the difference between both physicians was remarkable and statistically significant (80% vs. 50%, P=.047). In the following 20 FNABs, the difference narrowed and was not statistically significant (90% vs. 65%, P=.058). In the final 20 FNABs, the difference was minimal and not statistically significant (75% vs. 70%, P=.723). The learning curve of ultrasound-guided FNAB may be completed in a suitable environment by performing it at least 60 times. Although the guidelines recommend at least 3punctures per nodule, 2are enough to achieve an accurate percentage of diagnoses. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Capillary Versus Aspiration Biopsy: Effect of Needle Size and Length on the Cytopathological Specimen Quality

    International Nuclear Information System (INIS)

    Hopper, Kenneth D.; Grenko, Ronald T.; Fisher, Alicia I.; TenHave, Thomas R.

    1996-01-01

    Purpose: To test the value of the nonaspiration, or capillary, biopsy technique by experimental comparison with the conventional fine-needle aspiration technique using various needle gauges and lengths. Methods: On fresh hepatic and renal tissue from five autopsies, multiple biopsy specimens were taken with 20, 22, and 23-gauge Chiba needles of 5, 10, 15, and 20-cm length, using the aspiration technique and the capillary technique. The resultant specimens were graded on the basis of a grading scheme by a cytopathologist who was blinded to the biopsy technique. Results: The capillary technique obtained less background blood or clot which could obscure diagnostic tissue, although not significantly different from the aspiration technique (p= 0.2). However, for the amount of cellular material obtained, retention of appropriate architecture, and mean score, the capillary technique performed statistically worse than aspiration biopsy (p < 0.01). In addition, with decreasing needle caliber (increasing needle gauge) and increasing length, the capillary biopsy was inferior to the aspiration biopsy. Conclusion: The capillary biopsy technique is inferior to the aspiration technique according to our study. When the capillary technique is to be applied, preference should be given to larger caliber, shorter needles

  8. Enzyme immunoassay of oestrogen receptors in needle biopsies from human liver

    DEFF Research Database (Denmark)

    Becker, U; Andersen, J; Poulsen, H S

    1991-01-01

    For quantitative assessments of sex hormone receptors in liver tissue, ligand binding assays are inconvenient, as they require large biopsies (0.5-1.0 g). The present study shows that it is possible to measure oestrogen receptors (ER) quantitatively in needle biopsy specimens as small as 10 mg...... by modifications of a commercial enzyme immunoassay employing monoclonal antibodies. Sucrose gradient centrifugation and the dextran charcoal method served as reference methods. A consecutive series of needle biopsies from patients suspected of liver disease were investigated. The biopsies (n = 37) had a median...

  9. The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

    Directory of Open Access Journals (Sweden)

    Agata Stanek-Widera

    2016-05-01

    Full Text Available Fine needle aspiration biopsy (FNA is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE. We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100% cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100% provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100% specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment indicates that repeat FNA in order to confirm the diagnosis is unnecessary.

  10. Pseudoangiomatous Stromal Hyperplasia in Core Needle Biopsies of Breast Specimens.

    Science.gov (United States)

    Kelten Talu, Canan; Boyaci, Ceren; Leblebici, Cem; Hacihasanoglu, Ezgi; Bozkurt, Erol Rustu

    2017-02-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion of myofibroblasts that is composed of a network of slit-like channels that resemble vascular spaces. The aims of this study were to document the frequency of PASH in core needle biopsy specimens (CNBS) of the breast, to describe which histopathologic findings coexist with PASH and to examine any endothelial cell differentiation. We reevaluated hematoxylin and eosin-stained sections of all CNBS that were obtained during a 1-year period. First, we performed CD34 and CD31 immunostainings to highlight the areas of PASH, then performed D2-40/podoplanin (lymphatic endothelial marker) and Fli-1 (vascular endothelial cell marker) immunostains. The total number of CNBS was 412. Areas of PASH were noted in 37 of the 412 cases (9%), with a mean age of 38.5 years. The lesions that were described in association with PASH were "benign breast parenchyma with stromal fibrosis" (17/37; 46%), "fibroepithelial tumors" (17/37; 46%), "columnar cell changes (CCC)" (2/37; 5%), and "invasive carcinoma" (1/37; 3%). There were 2 cases of CCC within the foci of PASH (direct contact with PASH), and 8 additional cases of CCC that coexisted in the same specimen but were not in direct contact. There was no staining for D2-40 or Fli-1 within PASH foci. PASH lesions occurred with a frequency of 9% in CNBS and were mostly in association with benign breast lesions in premenopausal women. CCC was determined as an accompanying epithelial lesion within or near PASH areas. No obvious immunopositivity compatible with endothelial cell differentiation was revealed.

  11. Radiographer-performed stereotactic needle core biopsy: Making a difference

    Energy Technology Data Exchange (ETDEWEB)

    Dixon, Anne-Marie [School of Health Studies, University of Bradford, Unity Building, 25 Trinity Road, Bradford BD5 0BB (United Kingdom)], E-mail: a.m.dixon@leeds.ac.uk; Dearnley, Christine [School of Health Studies, University of Bradford, Unity Building, 25 Trinity Road, Bradford BD5 0BB (United Kingdom)

    2008-12-15

    This case study describes a qualitative investigation of the experiences of 14 experienced mammography radiographers who successfully undertook a formal programme of education and training in stereotactic needle core biopsy (SNCB) of the breast. They now routinely perform SNCB within symptomatic and screening breast services in a variety of NHS hospitals across the country. All 14 radiographers completed a semi-structured postal questionnaire approximately six months after the end of the course. A tentative theory derived from the data suggests that the professional challenge associated with radiographer-performed SNCB builds personal confidence and effects positive change. Three main categories emerging from the data - challenge, confidence and change are underpinned by two main themes - educational, professional and service drivers that promote the realisation of goals and vision; and personal, peer and external motivation sustained by respect, recognition and reward. SNCB role extension as explored in this study is having a positive and transformational impact on patient users of breast diagnostic clinical services and on the professional health carers providing them. The key drivers for this as identified in the study are a formal educational experience, professional role extension opportunities and the NHS modernisation process. The participants experienced positive change as individuals and as professional breast cancer multidisciplinary team members. Academic and financial rewards, respect and recognition from colleagues across professional disciplines and from patients, were key motivators that sustained the process. This study indicates that radiographer-performed SNCB can help deliver the NHS Plan and the NHS Cancer Plan and in doing so has the potential to improve the working lives of health care professionals and ultimately to improve the quality of care for patients.

  12. Radiographer-performed stereotactic needle core biopsy: Making a difference

    International Nuclear Information System (INIS)

    Dixon, Anne-Marie; Dearnley, Christine

    2008-01-01

    This case study describes a qualitative investigation of the experiences of 14 experienced mammography radiographers who successfully undertook a formal programme of education and training in stereotactic needle core biopsy (SNCB) of the breast. They now routinely perform SNCB within symptomatic and screening breast services in a variety of NHS hospitals across the country. All 14 radiographers completed a semi-structured postal questionnaire approximately six months after the end of the course. A tentative theory derived from the data suggests that the professional challenge associated with radiographer-performed SNCB builds personal confidence and effects positive change. Three main categories emerging from the data - challenge, confidence and change are underpinned by two main themes - educational, professional and service drivers that promote the realisation of goals and vision; and personal, peer and external motivation sustained by respect, recognition and reward. SNCB role extension as explored in this study is having a positive and transformational impact on patient users of breast diagnostic clinical services and on the professional health carers providing them. The key drivers for this as identified in the study are a formal educational experience, professional role extension opportunities and the NHS modernisation process. The participants experienced positive change as individuals and as professional breast cancer multidisciplinary team members. Academic and financial rewards, respect and recognition from colleagues across professional disciplines and from patients, were key motivators that sustained the process. This study indicates that radiographer-performed SNCB can help deliver the NHS Plan and the NHS Cancer Plan and in doing so has the potential to improve the working lives of health care professionals and ultimately to improve the quality of care for patients

  13. Assessment of bone biopsy needles for sample size, specimen quality and ease of use

    International Nuclear Information System (INIS)

    Roberts, C.C.; Liu, P.T.; Morrison, W.B.; Leslie, K.O.; Carrino, J.A.; Lozevski, J.L.

    2005-01-01

    To assess whether there are significant differences in ease of use and quality of samples among several bone biopsy needles currently available. Eight commonly used, commercially available bone biopsy needles of different gauges were evaluated. Each needle was used to obtain five consecutive samples from a lamb lumbar pedicle. Subjective assessment of ease of needle use, ease of sample removal from the needle and sample quality, before and after fixation, was graded on a 5-point scale. The number of attempts necessary to reach a 1 cm depth was recorded. Each biopsy specimen was measured in the gross state and after fixation. The RADI Bonopty 15 g and Kendall Monoject J-type 11 g needles were rated the easiest to use, while the Parallax Core-Assure 11 g and the Bard Ostycut 16 g were rated the most difficult. Parallax Core-Assure and Kendall Monoject needles had the highest quality specimen in the gross state; Cook Elson/Ackerman 14 g and Bard Ostycut 16 g needles yielded the lowest. The MD Tech without Trap-Lok 11 g needle had the highest quality core after fixation, while the Bard Ostycut 16 g had the lowest. There was a significant difference in pre-fixation sample length between needles (P<0.0001), despite acquiring all cores to a standard 1 cm depth. Core length and width decrease in size by an average of 28% and 42% after fixation. Bone biopsy needles vary significantly in performance. Detailed knowledge of the strengths and weaknesses of different needles is important to make an appropriate selection for each individual's practice. (orig.)

  14. Fine Needle Aspiration Biopsy in a Rural Family Practice

    African Journals Online (AJOL)

    ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10-mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and ...

  15. [Transabdominal chorionic villus sampling using biopsy forceps or needle: pregnancy outcomes by technique used].

    Science.gov (United States)

    Spallina, J; Anselem, O; Haddad, B; Touboul, C; Tsatsaris, V; Le Ray, C

    2014-11-01

    To compare pregnancy outcomes after transabdominal chorionic villus sampling using biopsy forceps or needle. Retrospective bicentric study including all women who had a transabdominal chorionic villus sampling between 2005 and 2009 (172 using biopsy forceps and 160 using needle). The primary endpoint was the rate of fetal loss, after excluding medical abortion due to the result of the biopsy. The secondary endpoint was the rate of premature rupture of the membrane. All cases were reviewed to try to determine the responsibility of the biopsy. The pregnancy outcomes were not different between the two groups: 4 (4.4%) fetal losses in the biopsy forceps group and 6 (7.4%) in the needle group (P=0.52). Only one case (1.2%) of fetal loss can be attributed to the biopsy, using a needle, and none (0%) following a forceps biospy (P=0.29). The rate of premature rupture of the membrane was comparable in the two groups. The pregnancy outcomes following chorionic villus sampling using a biopsy forceps or a needle seem comparable. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. CT fluoroscopy guided transpleural cutting needle biopsy of small ({<=}2.5 cm) subpleural pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, Helmut; Oschatz, Elisabeth; Eisenhuber, Edith; Wohlschlager, Helmut [Otto Wagner Hospital, Department of Radiology, Sanatoriumsstrasse 2, 1140 Vienna (Austria); Mostbeck, Gerhard H., E-mail: gerhard.mostbeck@wienkav.at [Otto Wagner Hospital, Department of Radiology, Sanatoriumsstrasse 2, 1140 Vienna (Austria)

    2011-01-15

    Purpose: Small subpleural pulmonary lesions are difficult to biopsy. While the direct, short needle path has been reported to have a lower rate of pneumothorax, the indirect path provides a higher diagnostic yield. Therefore, we tried to optimize the needle pathway and minimize the iatrogenic pneumothorax risk by evaluating a CT fluoroscopy guided direct approach to biopsy subpleural lesions. Material and methods: Between 01/2005 and 01/2007, CT fluoroscopy guided core biopsies were performed in 24 patients. Using our technique, the tip of the guide needle remains outside the visceral pleura (17 G coaxial guide needle, 18 G Biopsy-gun, 15 or 22 mm needle path). The position of the lesion relative to the needle tip can be optimized using CT fluoroscopy by adjusting the breathing position of the patient. The Biopty gun is fired with the needle tip still outside the pleural space. Cytological smears are analyzed by a cytopathologist on-site, and biopsies are repeated as indicated with the coaxial needle still outside the pleura. Results: Median nodule size was 1.6 cm (0.7-2.3 cm). A definitive diagnosis was obtained in 22 patients by histology and/or cytology. In one patient, only necrotic material could be obtained. In another patient, the intervention had to be aborted as the dyspnoic patient could not follow breathing instructions. An asymptomatic pneumothorax was present in seven patients; chest tube placement was not required. Conclusion: The presented biopsy approach has a high diagnostic yield and is especially advantageous for biopsies of small subpleural lesions in the lower lobes.

  17. Transrectal ultrasound: Diagnosis of prostate cancer by a new biplane US-guided biopsy technique. Comparison of thin-needle cytology and histology with large-core biopsy

    International Nuclear Information System (INIS)

    Lee, F.; Littrup, P.; McLeary, R.; Kumasaka, G.; Borlaza, G.; McHugh, T.; Soiderer, M.; Roi, L.

    1986-01-01

    A new transperineal biopsy technique was developed that uses biplane transrectal US guidance for needle placement into anechoic-hypoechoic lesions thought to indicate prostate cancer (n = 83). The results of histologic studies on biopsy material obtained with a 22-gauge needle and of aspiration histologic studies on biopsy material obtained with a 19-gauge needle were compared with results of histologic studies on material obtained with a 14-gauge needle. When sufficient tissue was obtained, the positive biopsy yield was 61% by cytology and 58% by histology; the combined yield was 61%. A limited study ( n = 21) of histologic findings in biopsy material obtained with 19-gauge and 14-gauge needles showed equivalent diagnostic results. Sixty-seven percent of the biopsies were of lesions less than 1.5 cm in diameter, and 57% (13 of 23) of the biopsy-proved cancers in this group were either nonpalpable or only mildly suspicious on digital rectal examination

  18. How accurate are measurements of skin-lesion depths on prebiopsy supine chest computed tomography for transthoracic needle biopsies?

    International Nuclear Information System (INIS)

    Cheung, Joo Yeon; Kim, Yookyung; Shim, Sung Shine; Lee, Jin Hwa; Chang, Jung Hyun; Ryu, Yon Ju; Lee, Rena J.

    2012-01-01

    Aim: To evaluate the accuracy of depth measurements on supine chest computed tomography (CT) for transthoracic needle biopsy (TNB). Materials and methods: We measured skin-lesion depths from the skin surface to nodules on both prebiopsy supine CT scans and CT scans obtained during cone beam CT-guided TNB in the supine (n = 29) or prone (n = 40) position in 69 patients, and analyzed the differences between the two measurements, based on patient position for the biopsy and lesion location. Results: Skin-lesion depths measured on prebiopsy supine CT scans were significantly larger than those measured on CT scans obtained during TNB in the prone position (p < 0.001; mean difference ± standard deviation (SD), 6.2 ± 5.7 mm; range, 0–18 mm), but the differences showed marginal significance in the supine position (p = 0.051; 3.5 ± 3.9 mm; 0–13 mm). Additionally, the differences were significantly larger for the upper (mean ± SD, 7.8 ± 5.7 mm) and middle (10.1 ± 6.5 mm) lung zones than for the lower lung zones (3.1 ± 3.3 mm) in the prone position (p = 0.011), and were larger for the upper lung zone (4.6 ± 5.0 mm) than for the middle (2.4 ± 2.0 mm) and lower (2.3 ± 2.3 mm) lung zones in the supine position (p = 0.004). Conclusions: Skin-lesion depths measured on prebiopsy supine chest CT scans were inaccurate for TNB in the prone position, particularly for nodules in the upper and middle lung zones.

  19. Determining the Optimal Number of Core Needle Biopsy Passes for Molecular Diagnostics.

    Science.gov (United States)

    Hoang, Nam S; Ge, Benjamin H; Pan, Lorraine Y; Ozawa, Michael G; Kong, Christina S; Louie, John D; Shah, Rajesh P

    2018-03-01

    The number of core biopsy passes required for adequate next-generation sequencing is impacted by needle cut, needle gauge, and the type of tissue involved. This study evaluates diagnostic adequacy of core needle lung biopsies based on number of passes and provides guidelines for other tissues based on simulated biopsies in ex vivo porcine organ tissues. The rate of diagnostic adequacy for pathology and molecular testing from lung biopsy procedures was measured for eight operators pre-implementation (September 2012-October 2013) and post-implementation (December 2013-April 2014) of a standard protocol using 20-gauge side-cut needles for ten core biopsy passes at a single academic hospital. Biopsy pass volume was then estimated in ex vivo porcine muscle, liver, and kidney using side-cut devices at 16, 18, and 20 gauge and end-cut devices at 16 and 18 gauge to estimate minimum number of passes required for adequate molecular testing. Molecular diagnostic adequacy increased from 69% (pre-implementation period) to 92% (post-implementation period) (p < 0.001) for lung biopsies. In porcine models, both 16-gauge end-cut and side-cut devices require one pass to reach the validated volume threshold to ensure 99% adequacy for molecular characterization, while 18- and 20-gauge devices require 2-5 passes depending on needle cut and tissue type. Use of 20-gauge side-cut core biopsy needles requires a significant number of passes to ensure diagnostic adequacy for molecular testing across all tissue types. To ensure diagnostic adequacy for molecular testing, 16- and 18-gauge needles require markedly fewer passes.

  20. Automated tru-cut imaging-guided core needle biopsy of canine ...

    African Journals Online (AJOL)

    The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single ...

  1. Diagnostic Value of ERG in Prostate Needle Biopsies Containing Minute Cancer Foci

    Directory of Open Access Journals (Sweden)

    Bachurska Svitlana Y.

    2017-03-01

    Full Text Available Background: Prostate carcinoma (PC is the second most diagnosed cancer in men population worldwide. The small amount of the tissue in prostate needle biopsy is often sufficient for the correct interpretation. Novel antibodies, as ERG, could add to the diagnostic value of IHC study in analysing difficult core biopsies.

  2. Bowel lesions: percutaneous US-guided 18-gauge needle biopsy--preliminary experience.

    Science.gov (United States)

    Tudor, G R; Rodgers, P M; West, K P

    1999-08-01

    Ultrasonography-guided percutaneous biopsy was performed with local anesthesia and an 18-gauge needle in 10 patients with bowel-wall lesions. All patients underwent clinical review within 1 month. Biopsy was diagnostic in all patients. There were no complications, and all patients tolerated the procedure well. The technique appears to be safe and had an excellent diagnostic yield in our series.

  3. Hematoma formation during breast core needle biopsy in women taking antithrombotic therapy.

    Science.gov (United States)

    Chetlen, Alison L; Kasales, Claudia; Mack, Julie; Schetter, Susann; Zhu, Junjia

    2013-07-01

    The purpose of this study was to compare hematoma formation after breast core needle biopsy performed on patients undergoing and those not undergoing concurrent antithrombotic therapy. A prospective assessment of core needle biopsies (stereotactic, ultrasound guided, or MRI guided) performed on patients enrolled between September 2011 and July 2012 formed the basis of this study. Postprocedure mediolateral and craniocaudal mammograms were evaluated for the presence and size of hematomas. Patients were clinically evaluated for complications 24-48 hours after the procedure through telephone call or face-to-face consultation. Needle size, type of biopsy, and presence of hematoma and documented complications were correlated with use of antithrombotic agents (including aspirin, warfarin, clopidogrel, and daily nonsteroidal antiinflammatory medications). No clinically significant hematomas or bleeding complications were found. Eighty-nine of 617 (14.4%) non-clinically significant hematomas were detected on postprocedure mammograms. The probability of development of a non-clinically significant hematoma was 21.6% for patients taking antithrombotics and 13.0% for those not taking antithrombotics. Concurrent antithrombotic therapy and larger needle gauge were significant factors contributing to the probability of hematoma formation. The volume of the hematoma was not related to needle gauge or presence of antithrombotic therapy. No clinically significant hematomas were found. Because there are potential life-threatening risks to stopping antithrombotic therapy before breast biopsy, withholding antithrombotic therapy for core needle breast biopsy is not recommended because the incidence of non-clinically significant hematoma is low.

  4. A cutting biopsy needle for the histological diagnosis of abdominal and retroperitoneal masses

    International Nuclear Information System (INIS)

    Hauenstein, K.H.; Wimmer, B.; Freudenberg, N.; Freiburg Univ.

    1985-01-01

    A new cutting biopsy needle has been used to obtain histologically useful material while causing the minimum of trauma. It permits biopsies of organs, but its small external diameter of 0.8 or 0.95 mm makes it possible to carry out transperitoneal puncture of the stomach, colon or liver and of the retroperitoneal space, using a ventral approach. Tissue samples were obtained in 96% of 63 patients. The risk of complications is no higher than for conventional needles used for cytology. The accuracy with which the material can be obtained is therefore the most important problem. The position of the area to be biopsied should determine whether the biopsy is to be aided by sonography or CT. Biopsies of organs can be appropriately carried out under ultrasound control, but processes in the pelvis and in retroperitoneal-paravertebral and extra-peritoneal positions are best biopsied under CT control. (orig.) [de

  5. Fine-needle trucut biopsy versus fine-needle aspiration cytology with ultrasound guidance in the abdomen

    International Nuclear Information System (INIS)

    O'Connell, A.M.; Keeling, F.; Given, M.; Logan, M.; Lee, M.J.

    2008-01-01

    Historically, fine-needle aspiration cytology (FNAC) has varying sensitivity, specificity and accuracy in the diagnosis of abdominal lesions with a high insufficient sampling rate. We compared 20-G fine-needle trucut biopsy (FNTB) with FNAC results in the biopsy of solid abdominal tumours. A retrospective review of 171 (128x 20-G FNTB and 43x FNAC) ultrasound-guided biopsies of abdominal tumours on 157 patients (male : female 85:72, mean age 61.25 years) were carried out. One hundred and seventy-one biopsies were carried out: liver 109, pancreas 19, lumph node 10, omentum 5, right iliac fossa mass 6, adrenal 6 and others 16. An average of 2.06 and 1.97 passes (range 1-4) were carried out per FNTB and FNAC, respectively. A definitive diagnosis was made in 122/128 biopsies (95.3%) and 32/43 biopsies (74.4%) for FNTB and FNAC, respectively. Diagnoses consisted of metastatic liver disease (74/171), pancreatic adenocarcinoma (10/171), lymphoma (8/171) and others (33/171) and benign (29/171). No significant complications occurred in either group. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 87, 100, 100, 50, 84.4 and 93.1, 100, 100, 60, 71.4 for FNTB and FNAC, respectively. A greater and more consistent positive diagnosis rate is yielded by 20-G FNTB (95.3%) that FNAC (74.4%). The diagnostic accuracy of FNTB is 84.4% cmopared with 69.8% for FNAC. A greater insufficient sampling rate occurs with FNAC (25.6%) than with FNTB (4.7%). For abdominal biopsy, 20-G FNTB needles have a much higher yield than FNAC with no increase in complications. FNTB is the preferred choice, particularly where cytological assistance at the time of biopsy is unavailable.

  6. Thin needle aspiration biopsy in diagnosis of thyroid gland carcinoma

    International Nuclear Information System (INIS)

    Nikolaeva, T. V.; Smolenskaya, N. A.; Rafeenko, S.M.; Rekechinskaya, N.V.; Krupnik, Ye.V.; Aladieva, L.A.; Krupnik, T. A.

    2001-01-01

    The increase of thyroid gland cancer in people of Belarus is one of the most actual medical problems appeared after the Chernobyl disaster. During the period 1986 -1999 in Belarus were revealed 6901 cases of cancer in the adults and 673 -in the children. Compared with the pre-disaster period the increase of the pathology has made 4.7 and 84 times correspondingly. In Magilew region during post-disaster years were revealed 899 cases of thyroid gland cancer in the adults and 34 -in the children. From the year 1998 perceptible rise of disease appeared in people over 19 years old. According to the prognosis of specialists the problem of high thyroid gland carcinoma rate will be actual for years, gradually decreasing in the children and increasing in the adults. Thyroid gland cancer promoted by radiation has very aggressive nature. According to the data of Republican science-practical thyroid gland tumors center even small carcinomas (3-9 mm) can give numerous metastasis to lymph nodes and lungs. The possibility of tumor growth to the nearest tissues is very high. That's why the early diagnostic of the pathology is important. Medical help to the patients with thyroid gland cancer and other node formations consist in the complex problem solution: early node formation revealing by ultrasonic method, early diagnosis verification with the help of cytological bio-assays examination, received by the way of the thin needle aspiration biopsy (TNAB) under ultrasonic control, surgical treatment, radio iodine therapy, rehabilitation and prophylactic medical examination. Under the problem of early thyroid carcinoma revealing they understand exact diagnostic and surgical treatment in the stages pT1, pT1a and pT1b, N0, M0. In 1993 -1999 in the diagnostic center 139,2 thousand patients were surveyed. In the pointed cases 10739 thin needle aspiration biopsies under ultrasonic control were made and the bioassays received were studied cytologically. Ultrasonic examinations and TNAB were

  7. Application of Real-Time 3D Navigation System in CT-Guided Percutaneous Interventional Procedures: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Priya Bhattacharji

    2017-01-01

    Full Text Available Introduction. To evaluate the accuracy of a quantitative 3D navigation system for CT-guided interventional procedures in a two-part study. Materials and Methods. Twenty-two procedures were performed in abdominal and thoracic phantoms. Accuracies of the 3D anatomy map registration and navigation were evaluated. Time used for the navigated procedures was recorded. In the IRB approved clinical evaluation, 21 patients scheduled for CT-guided thoracic and hepatic biopsy and ablations were recruited. CT-guided procedures were performed without following the 3D navigation display. Accuracy of navigation as well as workflow fitness of the system was evaluated. Results. In phantoms, the average 3D anatomy map registration error was 1.79 mm. The average navigated needle placement accuracy for one-pass and two-pass procedures, respectively, was 2.0±0.7 mm and 2.8±1.1 mm in the liver and 2.7±1.7 mm and 3.0±1.4 mm in the lung. The average accuracy of the 3D navigation system in human subjects was 4.6 mm ± 3.1 for all procedures. The system fits the existing workflow of CT-guided interventions with minimum impact. Conclusion. A 3D navigation system can be performed along the existing workflow and has the potential to navigate precision needle placement in CT-guided interventional procedures.

  8. Ultrasound-guided core needle biopsy in diagnosis of abdominal and pelvic neoplasm in pediatric patients.

    Science.gov (United States)

    Wang, Hailing; Li, Fangxuan; Liu, Juntian; Zhang, Sheng

    2014-01-01

    Ultrasound-guided core needle biopsy of abdominal and pelvic masses in adults has gained tremendous popularity. However, the application of the same treatment in children is not as popular because of apprehensions regarding inadequate tissues for the biopsy and accidental puncture of vital organs. Data of the application of ultrasound-guided core needle biopsy in 105 pediatric patients with clinically or ultrasound-diagnosed abdominopelvic masses were reviewed. Diagnostic procedures were conducted in our institution from May 2011 to May 2013. The biopsies were conducted on 86 malignant lesions and 19 benign lesions. 86 malignant tumors comprised neuroblastomas (30 cases), hepatoblastomas (15 cases), nephroblastomas (11 cases), and primitive neuroectodermal tumors/malignant small round cells (6 cases). Among malignant tumor cases, only a pelvic primitive neuroectodermal tumor did not receive a pathological diagnosis. Therefore, the biopsy accuracy was 98.8 % in malignant tumor. However, the biopsies for one neuroblastomas and one malignant small round cell tumor were inadequate for cytogenetic analysis. Therefore, 96.5 % of the malignant tumor patients received complete diagnosis via biopsy. 19 benign tumors comprised mature teratoma (10 cases), hemangioendothelioma (3 cases), paraganglioma (2 cases), and infection (2 cases). The diagnostic accuracy for benign neoplasm was 100 %. Five patients experienced postoperative complications, including pain (2 patients), bleeding from the biopsy site (2 patients), and wound infection (1 patient). Ultrasound-guided core needle biopsy is an efficient, minimally invasive, accurate, and safe diagnostic method that can be applied in the management of abdominal or pelvic mass of pediatric patients.

  9. The clinical application of percutaneous large core needle biopsy on large breast mass

    International Nuclear Information System (INIS)

    Peng Songhong; Ma Jie; Wang Guohong; Sun Guoping; Fu Jianmin; Zhou Dongxian

    2005-01-01

    Objective: An evaluation of the clinical application of percutaneous large core needle biopsy on large breast mass. Methods: Mammography and percutaneous large core needle biopsy were performed in 31 cases of large breast mass. Results: Apart from 5 cases showing characteristic calcification of malignancy, the rest cases were lack of diagnostic manifestation. Needle biopsy and pathological examination identified breast canner in 11 cases, suppurative mastitis in 9 case, fibrocystic mammary disorder in 7 cases, tuberculosis in 1 case, and fibroadenoma in 3 cases. Fibrocystic mammary disease was initially identified by biopsy in a case, while the following pathological diagnosis was fibrocystic mammary disorder with cancinoma in sim. Specificity rate of' biopsy was 96.8% and no false positive was observed. Vagotonia occurred in one case during the biopsy and hematoma in another. Conclusion: Percutaneous large core needle biopsy is a less invasive, simple, safe and reliable methods in the diagnosis of the large breast mass. And it may be recommended as a complementary procedure for routine imaging modality or surgical resection. (authors)

  10. Evaluation of The Value of Core Needle Biopsy in The Diagnosis of a Breast Mass

    Directory of Open Access Journals (Sweden)

    Asieh Sadat Fattahi

    2016-06-01

    Full Text Available Background: Core needle biopsy (CNB with histological findings is regarded as one of the most important diagnostic measures that make preoperative assessment and planning for appropriate treatment possible. The aim of this study was to determine the sensitivity and specificity of core biopsy results in our patients with benign and malignant breast lumps, especially for borderline breast lesions, by using a classification method.Methods: In this study, 116 patients who were referred to the Surgery Clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran with breast lump and underwent diagnostic procedures such as mammography and ultrasound were selected. Core needle biopsy (Tru-cut #14 or 16 was performed. After that, excisional biopsy was done. The benign, malignant and unspecified samples obtained by core needle biopsy were evaluated with the samples of the surgical and pathological findings. Then, false positive, false negative, sensitivity, specificity, and diagnostic accuracy of the core needle biopsy method were calculated. Also, the National Health Service Breast Screening Program (NHSBSP classification was employed.Results: The mean age of the participants in this study was 39±13.13 years and the mean tumor size was 2.7 cm. An average of 3.35 biopsies was taken from all patients. Most of the pathology samples taken from CNB and excisional biopsy were compatible with invasive ductal carcinoma. Of the B type classifications, B5 was the most frequent in both methods. Borderline lesions B3 and B4 had a change in their category after surgery. About 2.5% of the samples in core biopsy were inadequate. Skin bruising was the most common core biopsy complication reported. While, the most common complication of excisional biopsy was hematoma. Accuracy, sensitivity, specificity, positive and negative predictive values of the core needle biopsy procedure compared with excisional biopsy was 95.5%, 92.6%, 100%, 100%, and 91

  11. Value of percutaneous needle biopsy of small renal tumors in patients referred for cryoablation.

    Science.gov (United States)

    Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Sakurai, Jun; Matsui, Yusuke; Araki, Motoo; Nasu, Yasutomo; Kanazawa, Susumu

    2017-04-01

    To retrospectively evaluate the safety and diagnostic yield of needle biopsy of small renal tumors, and the clinical consequences of performing needle biopsy in patients referred for percutaneous cryoablation before their treatment. Biopsy was performed for 120 tumors (mean diameter, 2.2 cm) in 119 patients. All procedures were divided into diagnostic and non-diagnostic biopsies. Various variables were compared between the two groups. All cryoablation procedures were divided into two groups: procedures with or without simultaneous biopsy. The rates of benign or non-diagnostic tumors in each group were compared. After performing 120 initial and eight repeat biopsies, Grade 1 bleedings occurred in 44 cases. Six tumors were non-diagnostic and 114 were pathologically diagnosed. There were no significant variables between the diagnostic and non-diagnostic biopsies. Unnecessary cryoablation was avoided in nine benign lesions by performing biopsy in advance. Cryoablation performed simultaneously with biopsy included significantly more benign or non-diagnostic tumors than cryoablation performed after biopsy (15.2% vs. 1.4%; p = .01). Percutaneous biopsy of small renal tumors referred for cryoablation was a safe procedure with high diagnostic yield. The confirmation of pathological diagnosis prior to cryoablation is necessary because patients with benign tumors can avoid unnecessary treatment.

  12. Incidental intraductal papillomas (breast diagnosed on needle core biopsy do not need to be excised.

    Science.gov (United States)

    Jaffer, Shabnam; Bleiweiss, Ira J; Nagi, Chandandeep

    2013-01-01

    Most authors recommend excision of intraductal papillomas diagnosed on core needle biopsy. This leads to the question of whether or not excision is necessary for incidental intraductal papillomas on core needle biopsy as opposed to those corresponding to imaging findings. Using the pathology computerized data base we retrospectively identified 46 incidental intraductal papillomas diagnosed on core needle biopsy from 1/2000 to 12/2008. Clinical, radiologic, and pathologic information was gathered and correlated. All core needle biopsies were reviewed to confirm the diagnosis of incidental intraductal papillomas, and excision specimens reviewed when available. Of the 46 patients, follow-up information was available in only 38. The age of the patients ranged from 39 to 82 years (mean = 48 years). Most incidental intraductal papillomas were diagnosed by mammotome core needle biopsy (36 cases). A total of 33 cases were performed for calcifications with the following indications: clustered = 21, new = 4, pleomorphic = 3, increasing = 3, indeterminant = 2. The correlating diagnoses included the following: fibrocystic changes with calcium phosphate = 18 or calcium oxalate = 10, fibroadenoma with calcifications = 5. The three masses were: two cases of cystic papillary apocrine metaplasia (I Ultrasound and 1 MRI) and 1 fibroadenoma (Ultrasound). In all cases, the intraductal papillomas were ≤0.2 cm, were not associated with calcifications, and were incidental to them or the underlying mass. A total of 14 patients underwent excision, whereas the remaining 24 have remained radiologically stable for over 12 months. The excision specimen findings were: fibrocystic changes = 8 and intraductal papilloma = 6. With the exception of one case, all the intraductal papilloma remained incidental to imaging findings. In this solitary case, the calcifications were described as pleomorphic and corresponded to fibrocystic changes calcifications on core needle

  13. Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

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    Kohei Kobatake

    2015-04-01

    Full Text Available Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy. Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants and to the non-insertion group (group B: 130 participants. In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy. Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0% vs. 11 (8.5%, P=0.029. The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis. Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

  14. Accuracy of biopsy needle navigation using the Medarpa system - computed tomography reality superimposed on the site of intervention

    International Nuclear Information System (INIS)

    Khan, M. Fawad; Maataoui, Adel; Gurung, Jessen; Schiemann, Mirko; Vogl, Thomas J.; Dogan, Selami; Ackermann, Hanns; Wesarg, Stefan; Sakas, Georgios

    2005-01-01

    The aim of this work was to determine the accuracy of a new navigational system, Medarpa, with a transparent display superimposing computed tomography (CT) reality on the site of intervention. Medarpa uses an optical and an electromagnetic tracking system which allows tracking of instruments, the radiologist and the transparent display. The display superimposes a CT view of a phantom chest on a phantom chest model, in real time. In group A, needle positioning was performed using the Medarpa system. Three targets (diameter 1.5 mm) located inside the phantom were punctured. In group B, the same targets were used to perform standard CT-guided puncturing using the single-slice technique. The same needles were used in both groups (15 G, 15 cm). A total of 42 punctures were performed in each group. Post puncture, CT scans were made to verify needle tip positions. The mean deviation from the needle tip to the targets was 6.65±1.61 mm for group A (range 3.54-9.51 mm) and 7.05±1.33 mm for group B (range 4.10-9.45 mm). No significant difference was found between group A and group B for any target (p>0.05). No significant difference was found between the targets of the same group (p>0.05). The accuracy in needle puncturing using the augmented reality system, Medarpa, matches the accuracy achieved by CT-guided puncturing technique. (orig.)

  15. Imaging-guided percutaneous needle biopsy for infectious spondylitis: Factors affecting culture positivity

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    Sung, Si Yoon; Kwon, Jong Won [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-11-15

    To evaluate the variable factors affecting the results of percutaneous needle biopsies for infectious spondylitis. In all, 249 patients who underwent both MRI and percutaneous needle biopsies due to a suspicion of infectious spondylitis were evaluated with respect to the following factors: the usage of antibiotics before the procedure, the location of the biopsy, the guiding equipment used, the experience level of the operators, and the number of biopsies performed. The positivity of culture in cases of treated with antibiotics (16.3%) before the biopsy was lower than in the untreated cases (30.5%) (p = 0.004). Biopsies performed at the abscess (43.5%) and with fluoroscopic guidance (27.8%) showed higher culture positivity as well. The experience level of the operators and the number of biopsies had no effect on culture positivity. The usage of antibiotics before the biopsy, the biopsy's location, and the guiding equipment used affect the culture positivity, while the experience levels of the operators and the number of biopsies do not have an effect.

  16. Imaging-guided percutaneous needle biopsy for infectious spondylitis: Factors affecting culture positivity

    International Nuclear Information System (INIS)

    Sung, Si Yoon; Kwon, Jong Won

    2015-01-01

    To evaluate the variable factors affecting the results of percutaneous needle biopsies for infectious spondylitis. In all, 249 patients who underwent both MRI and percutaneous needle biopsies due to a suspicion of infectious spondylitis were evaluated with respect to the following factors: the usage of antibiotics before the procedure, the location of the biopsy, the guiding equipment used, the experience level of the operators, and the number of biopsies performed. The positivity of culture in cases of treated with antibiotics (16.3%) before the biopsy was lower than in the untreated cases (30.5%) (p = 0.004). Biopsies performed at the abscess (43.5%) and with fluoroscopic guidance (27.8%) showed higher culture positivity as well. The experience level of the operators and the number of biopsies had no effect on culture positivity. The usage of antibiotics before the biopsy, the biopsy's location, and the guiding equipment used affect the culture positivity, while the experience levels of the operators and the number of biopsies do not have an effect

  17. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

    International Nuclear Information System (INIS)

    Hemmer, Judith M.; Heesewijk, Hans P.M. van; Kelder, Johannes C.

    2008-01-01

    The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy. (orig.)

  18. Diagnostic accuracy of lymphoma established by fine-needle aspiration cytological biopsy

    Science.gov (United States)

    Delyuzar; Amir, Z.; Suryadi, D.

    2018-03-01

    Based on Globocan data in 2012, it is estimated that about 14,495 Indonesians suffer from lymphoma, both Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma. Some areas of specialization still doubt the accuracy of cytology diagnosis of fine needle aspiration biopsy.This study is a diagnostic test with a cross sectional analytic design to see how the cytology diagnostic accuracy of fine needle aspiration aspirate in lymphoma. It was in Department of Anatomical Pathology Faculty of Medicine USU, Haji Adam Malik Hospital, Dr.Pirngadi hospital, or private clinic in Medan. Peripheral cytology technique biopsy of fine needle aspiration on lymph node subsequently stained with Giemsa, when the cytology of lymphoma is obtained and confirmed by histopathologic examination. Cytology and histopathologic examination will be tested by Diagnostic Test and assessed for its sensitivity and specificity. The diagnostic of lymphoma cytology provides 93.33% sensitivity and 92.31% specificity when confirmed by histopathological examination. Positive predictive value and negative predictive value of 96.55% and 85.71% respectively. In conclusion, the cytology of fine needle aspiration biopsy is accurate enough to be used as a diagnostic tool, so it is advisable to establish a lymphoma diagnosis to perform a needle aspiration biopsy examination.

  19. Study on design and cutting parameters of rotating needles for core biopsy.

    Science.gov (United States)

    Giovannini, Marco; Ren, Huaqing; Cao, Jian; Ehmann, Kornel

    2018-06-15

    Core needle biopsies are widely adopted medical procedures that consist in the removal of biological tissue to better identify a lesion or an abnormality observed through a physical exam or a radiology scan. These procedures can provide significantly more information than most medical tests and they are usually performed on bone lesions, breast masses, lymph nodes and the prostate. The quality of the samples mainly depends on the forces exerted by the needle during the cutting process. The reduction of these forces is critical to extract high-quality tissue samples. The most critical factors that affect the cutting forces are the geometry of the needle tip and its motion while it is penetrating the tissue. However, optimal needle tip configurations and cutting parameters are not well established for rotating insertions. In this paper, the geometry and cutting forces of hollow needles are investigated. The fundamental goal of this study is to provide a series of guidelines for clinicians and surgeons to properly select the optimal tip geometries and speeds. Analytical models related to the cutting angles of several needle tip designs are presented and compared. Several needle tip geometries were manufactured from a 14-gauge cannula, commonly adopted during breast biopsies. The needles were then tested at different speeds and on different phantom tissues. According to these experimental measurements recommendations were formulated for rotating needle insertions. The findings of this study can be applied and extended to several biopsy procedures in which a cannula is used to extract tissue samples. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Nodular fasciitis of the face diagnosed by US-guided core needle biopsy: a case report

    International Nuclear Information System (INIS)

    Lee, Sang Kwon; Kwon, Sun Young

    2006-01-01

    We report here on a case of nodular fasciitis (NF) that was diagnosed by ultrasonography (US)-guided core needle biopsy in a 31-year-old man, and we include the US and computed tomographic (CT) findings and the histopathologic findings at US-guided core needle biopsy (CNB). We suggest that high-resolution US is useful for the detailed evaluation of NF in the superficial regions, such as the face, and US-guided CNB is useful for the definitive histologic diagnosis of NF without causing scarring

  1. Ultrasound guided percutaneous fine needle aspiration biopsy of the liver with focal lesion

    International Nuclear Information System (INIS)

    Ko, Gang Seok; Yang, Hyun Cheol; Park, Byoung Lan; Kim, Byoung Geun; Sohn, Jang Sihn

    1985-01-01

    The ultrasound-guided fine needle aspirations were performed in order to diagnose a suspected neoplastic or infectious disease in 52 patients with focal liver disease. Of these, neoplastic lesions were suspected in 31 patients and infectious lesions in 21 patients ultrasonically and/or clinically. The overall accuracy for both suspected malignant and infectious disease was 79% (41/52). The primary indication for fine needle aspiration was to document the presence of malignancy and to avoid a diagnostic laparotomy, and to drain hepatic abscess. Consequently we were convinced that the ultrasound-guided percutaneous fine needle aspiration biopsy in the focal liver disease is the best method for a conclusive diagnosis

  2. Scan-guided fine needle aspiration biopsy in malignant hepatic disease

    International Nuclear Information System (INIS)

    Johansen, P.; Svendsen, K.N.

    1978-01-01

    The method of scan-guided fine needle aspiration biopsy of the liver is described, and the diagnostic value of this combined method in the diagnosis of malignant hepatic disease is evaluated in 83 confirmed cases, showing a specificity of 100% and a sensitivity of 94%. The combined method is compared to liver scanning alone and to Menghini biopsy. Different methods for the diagnosis of malignant hepatic disease are discussed, and it is concluded that scan-guided fine needle aspiration biopsy has a diagnostic value only obtainable otherwise by a combination of liver scanning and biopsy during laparoscopy. Cytologic features in the two most common tumor types in this study, i.e., metastatic colonic adenocarcinoma and hepatocarcinoma, are presented along with a brief discussion of the specificity of the cytologic diagnosis of hepatocarcinoma

  3. Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration.

    Science.gov (United States)

    Jain, Ashali; Khalid, Maria; Qureshi, Muhammad M; Georgian-Smith, Dianne; Kaplan, Jonah A; Buch, Karen; Grinstaff, Mark W; Hirsch, Ariel E; Hines, Neely L; Anderson, Stephan W; Gallagher, Katherine M; Bates, David D B; Bloch, B Nicolas

    2017-11-01

    To evaluate breast biopsy marker migration in stereotactic core needle biopsy procedures and identify contributing factors. This retrospective study analyzed 268 stereotactic biopsy markers placed in 263 consecutive patients undergoing stereotactic biopsies using 9G vacuum-assisted devices from August 2010-July 2013. Mammograms were reviewed and factors contributing to marker migration were evaluated. Basic descriptive statistics were calculated and comparisons were performed based on radiographically-confirmed marker migration. Of the 268 placed stereotactic biopsy markers, 35 (13.1%) migrated ≥1 cm from their biopsy cavity. Range: 1-6 cm; mean (± SD): 2.35 ± 1.22 cm. Of the 35 migrated biopsy markers, 9 (25.7%) migrated ≥3.5 cm. Patient age, biopsy pathology, number of cores, and left versus right breast were not associated with migration status (P> 0.10). Global fatty breast density (P= 0.025) and biopsy in the inner region of breast (P = 0.031) were associated with marker migration. Superior biopsy approach (P= 0.025), locally heterogeneous breast density, and t-shaped biopsy markers (P= 0.035) were significant for no marker migration. Multiple factors were found to influence marker migration. An overall migration rate of 13% supports endeavors of research groups actively developing new biopsy marker designs for improved resistance to migration. • Breast biopsy marker migration is documented in 13% of 268 procedures. • Marker migration is affected by physical, biological, and pathological factors. • Breast density, marker shape, needle approach etc. affect migration. • Study demonstrates marker migration prevalence; marker design improvements are needed.

  4. Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion.

    Science.gov (United States)

    Rajawat, Govind Singh; Batra, Supreet; Takhar, Rajendra Prasad; Rathi, Lalit; Bhandari, Chand; Gupta, Manohar Lal

    2017-01-01

    Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. The objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy. This was a cross-sectional study. This study was conducted at Institute of Respiratory Diseases, SMS Medical College, Jaipur, a tertiary care center of West India. A total of 250 cases of pleural effusion were evaluated with complete pleural fluid biochemical, microbiological, and cytological examination. Out of these 250 patients, 59 were excluded from the study as the diagnosis could be established on initial pleural fluid examination. The remaining (191) patients were considered for closed pleural biopsy with Abrams pleural biopsy needle. The main outcome measure was diagnostic yield in the form of confirming diagnosis. Out of the 191 patients with exudative lymphocytic pleural effusion, 123 (64.40%) were diagnosed on the first pleural biopsy. Among the remaining 68 patients, 22 patients had repeat pleural biopsy with a diagnostic yield of 59.9%. The overall pleural biopsy could establish the diagnosis in 136 (71.20%) patients with pleural effusion. The most common diagnosis on pleural biopsy was malignancy followed by tuberculosis. Closed pleural biopsy provides diagnostic yield nearly comparative to thoracoscopy in properly selected patients of pleural effusions. In view of good yield, low cost, easy availability, and very low complication rate, it should be used routinely in all cases of undiagnosed exudative lymphocytic pleural effusion. There was no comparison with a similar group undergoing thoracoscopic pleural biopsy.

  5. CT-guided interventions in children

    International Nuclear Information System (INIS)

    Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A.

    2007-01-01

    In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

  6. Radiation exposure in CT-guided interventions

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    Kloeckner, Roman, E-mail: Roman.Kloeckner@unimedizin-mainz.de [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany); Santos, Daniel Pinto dos; Schneider, Jens [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany); Kara, Levent [Department of Radiology, Inselspital Bern, Freiburgstraße 18, 3010 Bern (Switzerland); Dueber, Christoph; Pitton, Michael B. [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany)

    2013-12-01

    Purpose: To investigate radiation exposure in computed tomography (CT)-guided interventions, to establish reference levels for exposure, and to discuss strategies for dose reduction. Materials and methods: We analyzed 1576 consecutive CT-guided procedures in 1284 patients performed over 4.5 years, including drainage placements; biopsies of different organs; radiofrequency and microwave ablations (RFA/MWA) of liver, bone, and lung tumors; pain blockages, and vertebroplasties. Data were analyzed with respect to scanner settings, overall radiation doses, and individual doses of planning CT series, CT intervention, and control CT series. Results: Eighy-five percent of the total radiation dose was applied during the pre- and post-interventional CT series, leaving only 15% applied by the CT-guided intervention itself. Single slice acquisition was associated with lower doses than continuous CT-fluoroscopy (37 mGy cm vs. 153 mGy cm, p < 0.001). The third quartile of radiation doses varied considerably for different interventions. The highest doses were observed in complex interventions like RFA/MWA of the liver, followed by vertebroplasty and RFA/MWA of the lung. Conclusions: This paper suggests preliminary reference levels for various intervention types and discusses strategies for dose reduction. A multicenter registry of radiation exposure including a broader spectrum of scanners and intervention types is needed to develop definitive reference levels.

  7. The efficacy of an ultrasound-guided core needle biopsy with an 18G cutting needle for the diagnosis of pancreatic diseases

    International Nuclear Information System (INIS)

    Jung, Sung Hwa; Park, Won Kyu; Chang, Jay Chun; Kim, Jae Woon; Cho, Jae Ho; Jang, Han Won; Lee, Jae Kyo; Choi, Joon Hyuk

    2008-01-01

    The objective of this study is to evaluate the efficacy and safety of an ultrasound-guided core needle biopsy with an 18G cutting needle in patients suspected of having a pancreatic disease by analyzing the diagnostic performance and complication rate. The study population comprised 35 consecutive patients who underwent an ultrasound-guided core needle biopsy using a high-speed biopsy gun accompanied with an 18G cutting-type needle between May of 2001 and October of 2005. The diagnostic performance (i.e., the acquisition rate and diagnostic accuracy) and complications associated with core needle biopsies were evaluated for its efficacy and safety. Thirty-six sessions of ultrasound-guided core needle biopsies were performed in 35 consecutive patients. All patients, except two (serous cystadenoma and autoimmune pancreatitis) were diagnosed with various subtypes of pancreatic cancer. The acquisition rate and diagnostic accuracy were 97% (35/36) and 94% (34/36), respectively. A complication occurred only in one patient (3%), which further proved to be a delayed complication (i.e., needle tract implantation). According to our findings, the ultrasound-guided core needle biopsy is a viable and safe method for the diagnosis of pancreatic diseases. Moreover, it enables the diagnosis of the pancreatic cancer subtype

  8. Axillary lymph node core biopsy for breast cancer metastases — How many needle passes are enough?

    International Nuclear Information System (INIS)

    Macaskill, E.J.; Purdie, C.A.; Jordan, L.B.; Mclean, D.; Whelehan, P.; Brown, D.C.; Evans, A.

    2012-01-01

    Aim: To determine the diagnostic yield of each of three core passes when sampling abnormal lymph nodes in patients presenting with breast cancer. Materials and methods: All patients suspected of having breast cancer had axillary ultrasound as part of initial assessment. Radiologically abnormal nodes (cortical thickness >2.3 mm or round shape) were biopsied with three passes of a 22 mm throw 14 G core biopsy needle and sent for histopathology in separate numbered pots. Data were collected prospectively, and analysis performed on the data of 55 consecutive patients who had positive nodes on at least one core biopsy needle pass. Results: Of 55 patients with a positive node on core biopsy, tumour was noted in all three cores taken in 39 (70.9%). Lymph node metastasis was detected in 45 (81.8%) first core biopsies. With the first two cores taken, positive results were detected in 53 of 55 cases (96.4%). In both cases where tumour was only found on a third core biopsy pass, no lymph node tissue was present in the first two biopsy passes. Conclusion: Two well-directed 14 G core biopsy samples from an abnormal axillary node are adequate for diagnosis of breast cancer metastasis.

  9. Fine needle aspiration biopsy of pancreas. Cytological assessment

    International Nuclear Information System (INIS)

    Coufal, L.; Heger, L.

    1987-01-01

    The benefits are presented of cytological examination of bioptical material from the pancreas using computerized tomography (CT) or ultrasound. The case is presented of one patient who had repeatedly undergone endoscopy with no results. Only cytological examination of material sampled using fine needle aspiration under CT control helped to immediately diagnose the process. The cytological finding correlated with the histological examination of material later taken during surgery. The problems are discussed of the differential diagnosis of tumors of the pancreas. (author). 5 figs., 9 refs

  10. Can concurrent core biopsy and fine needle aspiration biopsy improve the false negative rate of sonographically detectable breast lesions?

    Directory of Open Access Journals (Sweden)

    Chang Tsai-Wang

    2010-07-01

    Full Text Available Abstract Background The aims of this study were to determine the accuracy of concurrent core needle biopsy (CNB and fine needle aspiration biopsy (FNAB for breast lesions and to estimate the false-negative rate using the two methods combined. Methods Over a seven-year period, 2053 patients with sonographically detectable breast lesions underwent concurrent ultrasound-guided CNB and FNAB. The sonographic and histopathological findings were classified into four categories: benign, indeterminate, suspicious, and malignant. The histopathological findings were compared with the definitive excision pathology results. Patients with benign core biopsies underwent a detailed review to determine the false-negative rate. The correlations between the ultrasonography, FNAB, and CNB were determined. Results Eight hundred eighty patients were diagnosed with malignant disease, and of these, 23 (2.5% diagnoses were found to be false-negative after core biopsy. After an intensive review of discordant FNAB results, the final false-negative rate was reduced to 1.1% (p-value = 0.025. The kappa coefficients for correlations between methods were 0.304 (p-value p-value p-value Conclusions Concurrent CNB and FNAB under ultrasound guidance can provide accurate preoperative diagnosis of breast lesions and provide important information for appropriate treatment. Identification of discordant results using careful radiological-histopathological correlation can reduce the false-negative rate.

  11. CT Scan-Guided Abrams' Needle Pleural Biopsy versus Ultrasound-Assisted Cutting Needle Pleural Biopsy for Diagnosis in Patients with Pleural Effusion: A Randomized, Controlled Trial.

    Science.gov (United States)

    Metintas, Muzaffer; Yildirim, Huseyin; Kaya, Tamer; Ak, Guntulu; Dundar, Emine; Ozkan, Ragip; Metintas, Selma

    2016-01-01

    Image-guided pleural biopsies, both using ultrasound (US) or computed tomography (CT), are important in the diagnosis of pleural disease. However, no consensus exists regarding which biopsy needles are appropriate for specific procedures. In this randomized, prospective study, we aimed to compare CT scan-guided pleural biopsy using an Abrams' needle (CT-ANPB) with US-assisted pleural biopsy using a cutting needle (US-CNPB) with respect to both diagnostic yield and safety. Between February 2009 and April 2013, 150 patients with exudative pleural effusion who could not be diagnosed by cytological analysis were included in the study. The patients were randomized into either the US-CNPB group or the CT-ANPB group. The two groups were compared in terms of diagnostic sensitivity and complications. Of the 150 patients enrolled in this study, 45 were diagnosed with malignant mesothelioma, 46 were diagnosed with metastatic pleural disease, 18 were diagnosed with pleural tuberculosis, 34 were diagnosed with benign pleural disease, and 7 were lost to follow-up. In the US-CNPB group, the diagnostic sensitivity was 66.7%, compared with 82.4% in the CT-ANPB group; the difference between the two groups was statistically significant (p = 0.029). The sensitivity of CT-ANPB increased to 93.7% for patients with a pleural thickness ≥1 cm. The complication rates were low and acceptable. The first diagnostic intervention that should be preferred in patients with pleural effusion and associated pleural thickening on a CT scan is CT-ANPB. US-CNPB should be used primarily in cases for which only pleural thickening but no pleural effusion is noted. © 2016 S. Karger AG, Basel.

  12. Prospective evaluation of EUS-guided fine needle biopsy in pancreatic mass lesions

    DEFF Research Database (Denmark)

    Larsen, M H; Fristrup, C W; Detlefsen, S

    2018-01-01

    Background and study aim : Due to the scarcity of specific data on endoscopic ultrasound (EUS)-guided fine-needle biopsies (SharkCore) FNB in the evaluation of pancreatic lesions, we performed a prospective study of the diagnostic performance of EUS SharkCore FNB in patients with pancreatic lesions...

  13. Diagnostic accuracy of tuberculous lymphadenitis fine needle aspiration biopsy confirmed by PCR as gold standard

    Science.gov (United States)

    DSuryadi; Delyuzar; Soekimin

    2018-03-01

    Indonesia is the second country with the TB (tuberculosis) burden in the world. Improvement in controlling TB and reducing the complications can accelerate early diagnosis and correct treatment. PCR test is a gold standard. However, it is quite expensive for routine diagnosis. Therefore, an accurate and cheaper diagnostic method such as fine needle aspiration biopsy is needed. The study aimsto determine the accuracy of fine needle aspiration biopsy cytology in the diagnosis of tuberculous lymphadenitis. A cross-sectional analytic study was conducted to the samples from patients suspected with tuberculous lymphadenitis. The fine needle aspiration biopsy (FNAB)test was performed and confirmed by PCR test.There is a comparison to the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of both methods. Sensitivity (92.50%), specificity (96.49%), accuracy (94.85%), positive predictive value (94.87%) and negative predictive value (94.83%) were in FNAB test compared to gold standard. We concluded that fine needle aspiration biopsy is a recommendation for a cheaper and accurate diagnostic test for tuberculous lymphadenitis diagnosis.

  14. Risk of malignancy in fine-needle aspiration biopsy in patients with thyroid nodules

    DEFF Research Database (Denmark)

    Egset, Alice Viktoria; Holm, Camilla; Larsen, Stine Rosenkilde

    2017-01-01

    Introduction: Fine-needle aspiration biopsy (FNAB) is the cornerstone of thyroid nodule evaluation. In most cases, FNAB can discriminate between benign and malignant disease. In other cases, it is only indicative of malignancy and the results are considered “suspicious”. In Denmark, thyroid FNAB...

  15. The value of touch imprint cytology of prostate core needle biopsy ...

    African Journals Online (AJOL)

    The value of touch imprint cytology of prostate core needle biopsy specimens ... prostate cancer as indicated by a high prostate serum antigen (PSA) level or ... revealed benign features in 7 and prostatitis in 17, while high-grade prostatic ...

  16. False Negative Fine Needle Aspiration Biopsy Results in Primary Thyroid Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In Joong; Kim, Eun Kyung; Koh, Myoung Ju; Kwak, Jin Young; Moon, Hee Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography-guided fine needle aspiration biopsy (US-FNA) is one of the methods used to diagnose thyroid lymphoma, but it has a relatively high false-negative rate. The authors report a case of a primary thyroid lymphoma associated with underlying lymphocytic thyroiditis that was initially misdiagnosed as lymphocytic thyroiditis based on US-FNA findings

  17. CT-guided percutaneous treatment of solitary pyogenic splenic abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Pombo, F. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Suarez, I. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Marini, M. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Arrojo, L. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Echaniz, A. [Dept. of Internal Medicine, Hospital Juan Canalejo, La Coruna (Spain)

    1991-08-01

    Six patients with solitary pyogenic splenic abscesses treated by CT-guided percutaneous drainage (by catheter or needle), are presented. There were 3 unilocular, purely intrasplenic abscesses and 3 complex lesions with loculations and perisplenic involvement. Percutaneous drainage and intravenous antibiotics were curative in 4 patients. In the other 2, who had multiloculated abscesses, despite initially successful drainage, splenectomy was performed because of intractable left upper quadrant pain in one case and persistent fever and drainage of pus after 30 days in the other. These patients also developed large, sterile left pleural effusions. Solitary pyogenic splenic abscesses - particularly if uniloculated - can be effectively treated by CT-guided percutaneous drainage. (orig.)

  18. Histological diagnosis of ultrasound-visible breast lesions by large core needle biopsy

    International Nuclear Information System (INIS)

    Sanchis-Querol, E.; Valeros, O.; Collado, A.; Gimenez, J.; Yanguas, C.

    1999-01-01

    We present our experience in the histological diagnosis of breast lesions using ultrasound-guided large core needle biopsy (LCNB), assessing its utility as an alternative to excisional biopsy. We have studied retrospectively a series of 146 cases involving the performance of LCNB. The results were comparable with those of FNAB in 59 cases and with those of surgical aspiration biopsy in 105. Of the 113 lesions identified as malignant by percutaneous large core needle aspiration biopsy, 96 were resected. Surgical aspiration biopsy agreed with LCNB in 100% of cases. Of the 33 lesions identified as benign by LCNB, surgical biopsy detected malignancy in 5. The results obtained establish a specificity for LCNB of 100% and a sensitivity of 96%, both of which are superior to the values for FNAB. Thus, this technique can be considered valid for preoperative diagnosis. LCNB is useful in the preoperative diagnosis of breast lesions, making FNAB and surgical biopsy unnecessary. Moreover, it constitutes a significant change in the management of patients with malignant or undetermined breast lesions. (Author) 8 refs

  19. VALIDITY OF CORE NEEDLE BIOPSY IN THE HISTOPATHOLOGICAL VERIFICATION OF PAROTID GLAND LESIONS

    Directory of Open Access Journals (Sweden)

    Oroz Aleksandar

    2016-07-01

    Full Text Available Background and purpose: An adequate diagnosis of a parotid gland enlargement is crucial for an appropriate treatment. The aim of the study was to evaluate effectiveness and minimal invasiveness of diagnostic procedures of core-needle biopsy. Materials and Methods: This study involved 67 patients, aged 40 to 90 years, with a tumor mass in the submandibular and parotid region. Method used for taking samples of pathological masses was BD Disposable guillotine spring-loaded needle for biopsies on soft tissues. Final diagnoses were established on the basis of surgical-pathological results in 67 cases, and on the basis of histopathological analysis of core-biopsy samples. Results: Compared with results of surgical biopsy, core-needle biopsy had sensitivity of 100% in differentiating benign from malignant lesions and in setting up an adequate diagnosis. Its positive predictive values were 100% in diagnosing malignancy. There were found 28 non-malignant and 39 malignant lesions with fewer disadvantages for patients.

  20. Investigation of tissue cellularity at the tip of the core biopsy needle with optical coherence tomography.

    Science.gov (United States)

    Iftimia, Nicusor; Park, Jesung; Maguluri, Gopi; Krishnamurthy, Savitri; McWatters, Amanda; Sabir, Sharjeel H

    2018-02-01

    We report the development and the pre-clinical testing of a new technology based on optical coherence tomography (OCT) for investigating tissue composition at the tip of the core biopsy needle. While ultrasound, computed tomography, and magnetic resonance imaging are routinely used to guide needle placement within a tumor, they still do not provide the resolution needed to investigate tissue cellularity (ratio between viable tumor and benign stroma) at the needle tip prior to taking a biopsy core. High resolution OCT imaging, however, can be used to investigate tissue morphology at the micron scale, and thus to determine if the biopsy core would likely have the expected composition. Therefore, we implemented this capability within a custom-made biopsy gun and evaluated its capability for a correct estimation of tumor tissue cellularity. A pilot study on a rabbit model of soft tissue cancer has shown the capability of this technique to provide correct evaluation of tumor tissue cellularity in over 85% of the cases. These initial results indicate the potential benefit of the OCT-based approach for improving the success of the core biopsy procedures.

  1. Transjugular Core Liver Biopsy with a 19-Gauge Spring-Loaded Cutting Needle

    International Nuclear Information System (INIS)

    Choh, Jeffery; Dolmatch, Bart; Safadi, Rami; Long, Phil; Geisinger, Michael; Lammert, Gary; Dempsey, James

    1998-01-01

    One hundred and five sequential transjugular core liver biopsies (TJLBx) were performed in 101 patients with coagulopathy and/or ascites using the 19-gauge Quick-Core Biopsy (QCB) needle. Two-hundred and seventy-three cores were obtained in 295 passes (92.5%). One-hundred and two of the 105 procedures (97.1%) led to a histopathologic diagnosis. One of the three nondiagnostic biopsies was done because of severe autolysis of the liver. There was one subcapsular hematoma, one hepatic arteriovenous fistula, and one liver capsular puncture. Two minor neck hematomas occurred. One death was reported (unrelated to the procedure). QCB needle TJLBx is an effective and relatively safe way to obtain core liver samples

  2. CT fluoroscopy-guided core needle biopsy of anterior mediastinal masses.

    Science.gov (United States)

    Iguchi, T; Hiraki, T; Matsui, Y; Fujiwara, H; Sakurai, J; Masaoka, Y; Uka, M; Tanaka, T; Gobara, H; Kanazawa, S

    2018-02-01

    To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [±standard deviation] age, 53.8±20.0years; range, 14-88years) were analyzed. Final diagnoses were based on surgical outcomes, imaging findings, or clinical follow-up findings. The biopsy results were compared with the final diagnosis, and the biopsy procedures grouped by pathologic findings into diagnostic success and failure groups. Multiple putative risk factors for diagnostic failure were then assessed. Seventy-one biopsies (71 masses; mean size, 67.5±27.3mm; range 8.6-128.2mm) were analyzed. We identified 17 grade 1 and one grade 2 adverse events (25.4% overall) according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Sixty-nine biopsies (97.2%) provided samples fit for pathologic analysis. Diagnostic failure was found for eight (11.3%) masses; the 63 masses diagnosed successfully included thymic carcinoma (n=17), lung cancer (n=14), thymoma (n=12), malignant lymphoma (n=11), germ cell tumor (n=3), and others (n=6). Using a thinner needle (i.e., a 20-gauge needle) was the sole significant risk factor for diagnostic failure (P=0.039). CT fluoroscopy-guided biopsy of anterior mediastinal masses was safe and had a high diagnostic yield; however, using a thinner biopsy needle significantly increased the risk of a failed diagnosis. Copyright © 2017 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  3. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Martel, Jose [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain)], E-mail: jmartel@fhalcorcon.es; Bueno, Angel [Departamento de Diagnostico por Imagen, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain); Nieto-Morales, M Luisa [Servicio de Radiologia, Hospital Universitario de Tenerife (Spain); Ortiz, Eduardo J. [Departamento de Cirugia Ortopedica, Fundacion Hospital Alcorcon, Alcorcon, Madrid (Spain)

    2009-09-15

    CT-guided percutaneous radiofrequency ablation and laser photocoagulation have become the methods of choice for the treatment of all osteoid osteomas except those in contact with neural structures. We report 10 patients with spinal osteoid osteoma adjacent to the neural elements treated with 12 sessions of CT-guided monopolar radiofrequency ablation. The size range of the lesion was 3-14 mm (mean, 7.5 mm) and the distance between the nidus and the adjacent spinal cord or nerve root was 2-12 mm (mean, 5 mm). No intact cortex between the tumor and the spinal cord or nerve roots constituted an exclusion criterion because of a higher risk of undesirable neurotoxic effects. Patients were under general anesthesia. After location of the lesion, a 11G-bone biopsy was introduced into the nidus. The radiofrequency electrode was inserted through the biopsy needle and heated at 90 deg. C for 4 min. Primary success was obtained in eight patients. At follow-up (mean, 19.5 months; range, 6-24 months), pain persisted in two patients after 2 months. Both of them were re-treated. All patients are currently pain-free and complications were not detected. In our opinion, radiofrequency ablation can also be considered the treatment of choice for spinal osteoid osteoma.

  4. Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation

    International Nuclear Information System (INIS)

    Martel, Jose; Bueno, Angel; Nieto-Morales, M Luisa; Ortiz, Eduardo J.

    2009-01-01

    CT-guided percutaneous radiofrequency ablation and laser photocoagulation have become the methods of choice for the treatment of all osteoid osteomas except those in contact with neural structures. We report 10 patients with spinal osteoid osteoma adjacent to the neural elements treated with 12 sessions of CT-guided monopolar radiofrequency ablation. The size range of the lesion was 3-14 mm (mean, 7.5 mm) and the distance between the nidus and the adjacent spinal cord or nerve root was 2-12 mm (mean, 5 mm). No intact cortex between the tumor and the spinal cord or nerve roots constituted an exclusion criterion because of a higher risk of undesirable neurotoxic effects. Patients were under general anesthesia. After location of the lesion, a 11G-bone biopsy was introduced into the nidus. The radiofrequency electrode was inserted through the biopsy needle and heated at 90 deg. C for 4 min. Primary success was obtained in eight patients. At follow-up (mean, 19.5 months; range, 6-24 months), pain persisted in two patients after 2 months. Both of them were re-treated. All patients are currently pain-free and complications were not detected. In our opinion, radiofrequency ablation can also be considered the treatment of choice for spinal osteoid osteoma.

  5. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

    Directory of Open Access Journals (Sweden)

    Julian Arista-Nasr

    2016-04-01

    Full Text Available ABSTRACT Purpose The vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. Materials and Methods We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Results Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin (34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years. Conclusions The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

  6. High velocity pulse biopsy device enables controllable and precise needle insertion and high yield tissue acquisition.

    Science.gov (United States)

    Schässburger, Kai-Uwe; Paepke, Stefan; Saracco, Ariel; Azavedo, Edward; Ekström, Christina; Wiksell, Hans

    2018-02-01

    Minimally invasive biopsies are a cornerstone of breast cancer management with ultrasound being the preferred guidance modality. New developments in breast cancer management and advances in imaging technologies bring new challenges to current biopsy methodologies. A new biopsy device (NeoNavia® biopsy system, 14 G) was developed. It incorporates a pneumatic needle insertion mechanism that is intended to provide better control of needle progression and enable stepwise insertion without noticeable deformation or displacement of surrounding tissue as visualized under ultrasound. A new method of tissue acquisition was designed to achieve a sampling yield higher than standard methodologies. Needle dynamics was assessed on a specifically designed test bed and sampling performance was compared to a Magnum® biopsy instrument (Bard, Covington, GA, USA) in representative tissue models. The histological quality of samples obtained ex-vivo was evaluated. A pneumatic pulse was measured to accelerate the needle to a maximum velocity of 21.2 ± 2.5 m/s on a stroke length of 2.5 mm, achieving significantly higher acceleration, maximum velocity and power than current biopsy devices. Mean weight of samples obtained by the NeoNavia device were 3.5, 4.6, and 4.3 times higher when sampling was performed in turkey breast, calf thymus and swine pancreas, respectively, as compared to samples obtained with the Magnum instrument. Ex-vivo analysis indicates that the method of tissue acquisition has no apparent negative impact on the histopathologic quality of obtained samples. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Ultrasound-guided percutaneous core needle biopsy of abdominal viscera: Tips to ensure safe and effective biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Woong; Shin, Sang Soo [Chonnam National University Hospital, Chonnam National University Medical School, Gwangju(Korea, Republic of)

    2017-04-15

    Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications.

  8. Ultrasound-guided percutaneous core needle biopsy of abdominal viscera: Tips to ensure safe and effective biopsy

    International Nuclear Information System (INIS)

    Kim, Jin Woong; Shin, Sang Soo

    2017-01-01

    Ultrasound-guided percutaneous core needle biopsy (USPCB) is used extensively in daily clinical practice for the pathologic confirmation of both focal and diffuse diseases of the abdominal viscera. As a guidance tool, US has a number of clear advantages over computerized tomography or magnetic resonance imaging: fewer false-negative biopsies, lack of ionizing radiation, portability, relatively short procedure time, real-time intra-procedural visualization of the biopsy needle, ability to guide the procedure in almost any anatomic plane, and relatively lower cost. Notably, USPCB is widely used to retrieve tissue specimens in cases of hepatic lesions. However, general radiologists, particularly beginners, find USPCB difficult to perform in abdominal organs other than the liver; indeed, a full understanding of the entire USPCB process and specific considerations for specific abdominal organs is necessary to safely obtain adequate specimens. In this review, we discuss some points and techniques that need to be borne in mind to increase the chances of successful USPCB. We believe that the tips and considerations presented in this review will help radiologists perform USPCB to successfully retrieve target tissue from different organs with minimal complications

  9. Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

    Directory of Open Access Journals (Sweden)

    Ewa Łukasiewicz

    2017-12-01

    Full Text Available Aim: The aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy. Material and methods: Fifty-five articles (original papers and reviews, half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account. Results: Pre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index. Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs. Conclusions: Microscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more

  10. Comparison of needles size in pediatric renal biopsy with sono-guided percutaneous-automated gun technique

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Park, Jin Yong

    1997-01-01

    To compare the efficacy of a 20-gauge and an 18-gauge needle in sono-guided percutaneous automated gun biopsy for establishing the specific diagnosis of renal parenchymal disease in pediatric kidneys. In 60 pediatric patients with renal parenchymal diseases, percutaneous sono-guided gun biopsy was performed by an experienced radiologist. In two groups of 30 patients, regardless of their age, two needle passes were performed, using alternately an 18-gauge or a 20-gauge biopsy needle. The core of renal tissue thus obtained was examined with light, immunofluorescent or electron microscopy by the renal pathologist. The mean number of intact glomeruli of whole tissue core per biopsy, as seen on the light microscopy, and post-bioptic complications were compared between the two different needle size groups. The number (mean±1 standard deviation) of glomeruli obtained per biopsy was 17±8 in the 18-gauge needle group, and 14±5 in the 20-gauge group. Between two groups, there was no major post-bioptic complication requiring specific treatment, nor a statistically significant difference in the frequency of minor complications. Even though more glomeruli were obtained with an 18-gauge needle, the number obtained with a 20-gauge needle also permitted adequate pathologic examination. Both an 18-gauge and a 20-gauge needle may thus be suitable for renal biopsy in pediatric patients

  11. Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

    2011-03-15

    Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

  12. Image-guided core-needle biopsy of peripheral lymph nodes allows the diagnosis of lymphomas

    International Nuclear Information System (INIS)

    Kerviler, Eric de; Bazelaire, Cedric de; Mathieu, Olivier; Frija, Jacques; Mounier, Nicolas; Gisselbrecht, Christian; Brethon, Benoit; Briere, Josette; Marolleau, Jean-Pierre; Brice, Pauline

    2007-01-01

    It is commonly admitted that the diagnosis of lymphomas can be assessed by the image-guided needle biopsy (IGNB) of deep lymph nodes. However, when peripheral lymph nodes are present, surgical dissection remains the standard strategy. The aim of this study was to evaluate the diagnostic yield of IGNB of peripheral lymph nodes in patients with suspected lymphomas. The records of 180 multisampling IGNBs of peripheral lymph nodes in 180 patients were reviewed. One hundred and twenty-three IGNBs were observed at first diagnosis and 57 at progression using large-cutting core-biopsy needles ranging between 18 G and 14 G in size. Immunohistochemistry studies were performed in all cases and at least one biopsy was systematically frozen. A diagnosis of lymphoma with sufficient information such that a therapeutic decision could be made was obtained in 146 of the 152 patients with lymphoproliferative disorders (96%). IGNB was equally effective in making the correct diagnosis of lymphoma at the time of original diagnosis than at relapse. The results did not depend on the biopsy site, lymph nodes size, or needle type. We recommend that IGNB may be performed as an initial procedure for the diagnosis of lymphomas either in the presence of peripheral or deep lymph nodes, as it avoids surgery. (orig.)

  13. The effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety.

    Science.gov (United States)

    Hızlı, Fatih; Özcan, Osman; Selvi, İsmail; Eraslan, Pınar; Köşüş, Aydın; Baş, Okan; Yıkılmaz, Taha Numan; Güven, Oğuz; Başar, Halil

    2015-11-01

    Several studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 ± 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 ± 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.

  14. Does imprint cytology improve the accuracy of transrectal prostate needle biopsy?

    Science.gov (United States)

    Sayar, Hamide; Bulut, Burak Besir; Bahar, Abdulkadir Yasir; Bahar, Mustafa Remzi; Seringec, Nurten; Resim, Sefa; Çıralık, Harun

    2015-02-01

    To evaluate the accuracy of imprint cytology of core needle biopsy specimens in the diagnosis of prostate cancer. Between December 24, 2011 and May 9, 2013, patients with an abnormal DRE and/or serum PSA level of >2.5 ng/mL underwent transrectal prostate needle biopsy. Samples with positive imprint cytology but negative initial histologic exam underwent repeat sectioning and histological examination. 1,262 transrectal prostate needle biopsy specimens were evaluated from 100 patients. Malignant imprint cytology was found in 236 specimens (18.7%), 197 (15.6%) of which were confirmed by histologic examination, giving an initial 3.1% (n = 39) rate of discrepant results by imprint cytology. Upon repeat sectioning and histologic examination of these 39 biopsy samples, 14 (1.1% of the original specimens) were then diagnosed as malignant, 3 (0.2%) as atypical small acinar proliferation (ASAP), and 5 (0.4%) as high-grade prostatic intraepithelial neoplasia (HGPIN). Overall, 964 (76.4%) specimens were negative for malignancy by imprint cytology. Seven (0.6%) specimens were benign by cytology but malignant cells were found on histological evaluation. On imprint cytology examination, nonmalignant but abnormal findings were seen in 62 specimens (4.9%). These were all due to benign processes. After reexamination, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate of imprint preparations were 98.1, 96.9, 98.4, 92.8, 99.3, 1.6, 3.1%, respectively. Imprint cytology is valuable tool for evaluating TRUS-guided core needle biopsy specimens from the prostate. Use of imprint cytology in combination with histopathology increases diagnostic accuracy when compared with histopathologic assessment alone. © 2014 Wiley Periodicals, Inc.

  15. A Novel Design of Needle Aspiration Biopsy Monitoring Instrument (NAOMI Tested on a Low Cost Chest Phantom

    Directory of Open Access Journals (Sweden)

    Surakusumah Rino Ferdian

    2016-01-01

    Full Text Available Needle biopsy is a medical intervention method for taking a lung tissue sample that suspected as a cancer. The disadvantage is the physicians directly visualize the anatomical structures in an open surgery for lung cancer biopsy procedure. There is a need to develop an instrument that may help the physician to guarantee the accuracy and efficiency while performing needle aspiration biopsy. Therefore, a needle aspiration biopsy monitoring instrument or named as NAOMI is proposed. It consists of a microcontroller system, an IMU sensor, an ultrasonic ranging module, a bluetooth module, and a 9V lithium battery. The experimental testing consist of performance testing, functional testing using chest phantom, and user acceptances. The results showed that the NAOMI improve the accuracy and efficiency while performing the needle biopsy operation.

  16. Upright stereotactic vacuum-assisted needle biopsy of suspicious breast microcalcification

    International Nuclear Information System (INIS)

    Sim, L. S. J.; Kei, P. L.

    2008-01-01

    Full text: Stereotactic core needle biopsy is a useful technique for evaluation of suspicious breast microcalcifications. Thf development of the 11-G vacuum-assisted biopsy system offers another method of minimally invasive biopsy carried out on a conventional mammography unit. We evaluate its usefulness, efficacy and safety in Asian women.. Vacuum-assisted biopsy was carried out through the lateral approach using an add-on stereotactic device attached to a mammography unit. One hundred and five lesions were sampled in 97 patients. Excisional biopsy was subsequently Carried out for diagnosis of atypical ductal hyperplasia or carcinoma in high-risk patients. Patients with benign diagnosis underwent mammographic follow up. The technical success rate was 97%. An average of 13.5 tissue cores were retrieved for each lesion. The histopathological result obtained from mammotome was benign in 84.8% and malignant in 15.2%. The benign microcalcifications were predominantly fibrocystic change (n = 42)| whereas the malignant microcalcifications included ductal carcinoma in situ (n = 15) and invasive carcinoma (n = 1). Twenty-two patients underwent subsequent open surgical biopsy but no underestimation of disease was seen. Only two patients had vasovagal syncope and three others felt unwell during the biopsy. Nine patients had small haema-1 tomas, which resolved spontaneously. Vacuum-assisted biopsy carried out on an upright stereotactic mammography] unit is a safe and effective method for evaluation of suspicious microcalcifications.

  17. Association of serum prostate-specific antigen levels with the results of the prostate needle biopsy.

    Science.gov (United States)

    Janbaziroudsari, Hamid; Mirzaei, Arezoo; Maleki, Nasrollah

    2016-09-01

    To investigate the relationship of serum prostate-specific antigen (PSA) levels with outcomes of prostate needle biopsy in men 50 or more years old. We measured serum PSA levels in 1472 healthy men 50 or more years old. Men who had serum PSA values 4.0ng/mL or higher underwent digital rectal examination. If there were either an elevated PSA level (≥4ng/mL) or abnormal digital rectal examination, a transrectal ultrasound-guided prostate biopsy was performed. The mean serum total PSA level was 13.73±11.44ng/mL, and the mean serum free PSA level was 4.99±0.97ng/mL. Of the 260 men who had serum total PSA levels of≥4ng/mL, 139 underwent biopsy. Of these 139 men, 45 (32.4%) had prostate cancer. Benign prostatic hyperplasia with or without prostatitis was diagnosed in 94 patients (67.6%). There was no significant correlation between age and histologic results of prostate needle biopsy (P-value=0.469). The serum free PSA showed no significant correlation with histologic results of prostate needle biopsy, whereas the serum total PSA level had a significant correlation in patients with adenocarcinoma compared with other diagnosis. The overall frequency of detection of prostate adenocarcinoma was 32.4%. This study revealed that no level of PSA was associated with a 100% positive predictive value and negative biopsy can occur virtually at any PSA level. There is a need to create awareness among the general population and health professionals for an early diagnosis of this common form of cancer. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  18. Diagnostic efficacy of ultrasound-guided core-needle biopsy of peripheral lymph nodes in sarcoidosis.

    Science.gov (United States)

    Boussouar, S; Medjhoul, A; Bernaudin, J F; Tayebjee, O; Soussan, M; Uzunhan, Y; Nunes, H; Kambouchner, M; Martin, A; Valeyre, D; Brillet, P Y

    2015-09-14

    Core-needle biopsy guided by ultrasound can be performed for investigating peripheral lymph node (PLN). The aim of this study was to determine the efficacy of this technique in sarcoidosis. Retrospective review of files of all patients in the database of the radiology department of Avicenne university hospital who underwent PLN biopsies guided by ultrasound from January 2008 to June 2011 (n=292). Cases with either granulomas at histology with the procedure or with a final diagnosis of sarcoidosis were included in the study. The histological specimens were adequate in 282 out of 292 cases (96%) showing non-caseating granulomas in 22 cases (n=20 patients with a final diagnosis of sarcoidosis and n=2 patients with tuberculosis). After reviewing clinical files of the 282 patient, 22 were confirmed to have sarcoidosis, at initial presentation (n=19) or later during flare-up or relapse (n=3) with only 2 patients having no granuloma on PLN biopsy. PLN were palpable in 18 cases and only detected by (18F)FDG-PET/CT showing increased PLN uptake in 4 cases. The sensitivity and specificity of adequate biopsy were 91 and 99% and the positive and negative predictive values were 91 and 99%, respectively. Core-needle biopsy guided by ultrasound has a high efficacy for evidencing granulomas in sarcoidosis patients with PLN involvement either clinically palpable or in the presence of (18F)FDG-PET/CT uptake.

  19. Value of fine-needle aspiration biopsy of salivary gland lesions

    DEFF Research Database (Denmark)

    Christensen, Rikke Kølby; Bjørndal, Kristine; Godballe, Christian

    2010-01-01

    BACKGROUND: The aim of this study was to assess the utility of fine-needle aspiration biopsy (FNAB) in the diagnosis and treatment planning of the lesions of the salivary gland. METHODS: Eight hundred seventy-nine aspiration biopsies of the lesion of the salivary gland over a 10-year period, from...... was 98%, and the negative predictive value was 97%. The overall accuracy was 93%. The correct subtyping of the benign lesions was 97%, and the exact type-specific concordance of the malignant lesions was 71%. CONCLUSION: Considerable benefit to the patient may result from the cautious use of FNAB...

  20. [Lung Abscess Diagnosed as Adenocarcinoma by Needle Biopsy;Report of a Case].

    Science.gov (United States)

    Shomura, Shin; Suzuki, Hitoshi; Yada, Masaki; Kondo, Chiaki

    2015-07-01

    We report a case of lung abscess misdiagnosed as adenocarcinoma based on cytologic findings of the sample obtained from needle biopsy. A 45-year-old man consulted our hospital because of fever, wet cough and an abnormal shadow on a chest X-ray film. A chest computed tomography revealed gradually enlarging pulmonary mass in the left S6 infiltrating the S5. A diagnosis of lung cancer was suspected and surgery was performed. Pathological findings of the specimen showed atypical cells with a large nucleus and a gross papillary neoplasm by needle biopsy. The patient underwent left lower lobectomy and partial resection of upper lobe with standard nodal dissection. The final diagnosis was a lung abscess with pneumonia without evidence of malignancy. When an indeterminate pulmonary tumor must be diagnosed during an operation, we should perform partial resection if possible.

  1. Risk factors of pneumothorax in percutaneous fine needle aspiration biopsy of the lung

    International Nuclear Information System (INIS)

    Kim, Sang Jin; Park, Kwang Joo; Shin, Hyung Cheol; Kwon, Ryang; Jo, Byung June; Oh, Sei Jung; Ahn, Chang Su; Kim, Hyung Jung

    1997-01-01

    Percutaneous fine needle aspiration biopsy is known to be a useful diagnostic method for the diagnosis of various pulmonary diseases. Its diagnostic yield is high, and it is safe, but complications such as pneumothorax can occasionally occur. We reviewed the complications arising after needle aspiration biopsy and analyzed the risk factors of pneumothorax. The medical records and radiographic studies of 157 patients with various pulmonary diseases who underwent needle aspiration biopsy of the lung between 1990 and 1996 were retrospectively reviewed. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, diameter of needle, number of punctures, and obstructive pulmonary abnormalities were analyzed. Complications occurred in 40 of 157cases(25.5%), namely pneumothorax in 26(16.6%), hemoptysis in 11(7%), hemothorax in two(1.3%), and recurrence of malignancy at the site of aspiration in one(0.6%). When the patients were divided into three groups according to depth of lesion, there were significant difference in the incidence of pneumothorax;the results were as follows:less than 2cm, 12.9%;between 2 and 4cm, 24.1%;and larger than 4cm, 57.1%(p<0.05). In pulmonary function testing, FVC(Forced Vital Capacity) of patients with pneumothorax was less than that of patients without(2.6±0.9L vs 3.1±0.8L, p<0.05), but FEV1(Forced Expiratory Volume in 1 second), FEV1%(percentage of predicted FEV1), FEV1/FVC, and FVC% (percentage of predicted FVC) were not different between the two groups. The incidence of pneumothorax in patients with pleura-at-tached lesion (9%) was lower than that of those with non-attached lesion(26%, p=3D0.01). The age of patients, size of lesion, diameter of the needle, guidance methods and number of aspirations showed no significant relationship with pneumothorax. In needle aspiration biopsy of the lung, depth of lesion and passage of a needle through aerated lung are

  2. Fine needle biopsy of thyroid nodules: correlations between cytology and gistology, technical aspects

    Directory of Open Access Journals (Sweden)

    Yu Fedotov

    2009-12-01

    Full Text Available The results of comparative preoperative cytological and postoperative histological investigation of 3714 patients with thyroid nodules are presented. The causes of discrepancies are discussed and measures of their diminution are proposed. Great value of fine needle biopsy to differ thyroid nodules but follicular neoplasia into benign and malignant are determined. Its sensitivity in our clinics is 98.7% and specificity – 100%. Necessity of the of the second FNA if the first one is non informative is established.

  3. Determination of Magnesium in Needle Biopsy Samples of Muscle Tissue by Means of Neutron Activation Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Brune, D; Sjoeberg, H E

    1964-07-15

    Magnesium has been determined by means of neutron-activation analysis in needle biopsy samples of the order of magnitude 1 mg dry weight. The procedure applied was to extract the Mg-27 activity from irradiated muscle tissue with concentrated hydrochloric acid followed by a fast hydroxide precipitation and gamma-spectrometric measurements. The Mg activity was recovered in the muscle tissue samples to (97 {+-} 2) per cent. The sensitivity for the magnesium determination is estimated as 0.3 {mu}g.

  4. Effect of a Biopsy Center on Adequacy Rates of Thyroid Nodule Fine-Needle Aspiration.

    Science.gov (United States)

    Leung, Vincent A; Kirpalani, Anish; Mnatzakanian, Gevork; Colak, Errol; Vlachou, Paraskevi A

    2017-08-01

    The purpose of this study was to investigate the effect of a biopsy center-a dedicated space with a dedicated ultrasound machine and technologist, staffed daily by a radiologist responsible for performing ultrasound-guided procedures only-on the rate of non-diagnostic or unsatisfactory thyroid fine-needle aspiration (FNA). Three radiologists performed FNA on 1200 nodules in 998 patients between September 2010 and November 2015. We compared rates of nondiagnostic or unsatisfactory FNA before and after implementation of a biopsy center in September 2014 as part of a quality improvement initiative. Before the establishment of our biopsy center, ultrasound-guided procedures were scheduled between diagnostic studies in the main ultrasound department and were performed by a radiologist responsible for both. Multivariate logistic regression analysis was performed to assess the effect of the biopsy center on the odds of obtaining an adequate sample. Rates of nondiagnostic or unsatisfactory FNA decreased significantly from 15.1% to 8.5% (p < 0.001) after implementation of the biopsy center. The odds of obtaining an adequate sample were higher in the biopsy center (odds ratio, 2.07; 95% CI, 1.43-3.01), even after adjusting for patient age, nodule size, the radiologist performing the procedure, and time over the study period. The implementation of a biopsy center was associated with significantly lower rates of nondiagnostic or unsatisfactory thyroid FNA, suggesting target rates of 10% or lower are achievable with quality improvement measures.

  5. Patient identification error among prostate needle core biopsy specimens--are we ready for a DNA time-out?

    Science.gov (United States)

    Suba, Eric J; Pfeifer, John D; Raab, Stephen S

    2007-10-01

    Patient identification errors in surgical pathology often involve switches of prostate or breast needle core biopsy specimens among patients. We assessed strategies for decreasing the occurrence of these uncommon and yet potentially catastrophic events. Root cause analyses were performed following 3 cases of patient identification error involving prostate needle core biopsy specimens. Patient identification errors in surgical pathology result from slips and lapses of automatic human action that may occur at numerous steps during pre-laboratory, laboratory and post-laboratory work flow processes. Patient identification errors among prostate needle biopsies may be difficult to entirely prevent through the optimization of work flow processes. A DNA time-out, whereby DNA polymorphic microsatellite analysis is used to confirm patient identification before radiation therapy or radical surgery, may eliminate patient identification errors among needle biopsies.

  6. Is stereotactic large-core needle biopsy beneficial prior to surgical treatment in BI-RADS 5 lesions?

    NARCIS (Netherlands)

    Hoorntje, LE; Peeters, PHM; Mali, WPTM; Rinkes, IHMB

    Introduction. Due to screening mammography, more nonpalpable mammographic lesions warrant histological evaluation. Stereotactic large-core needle biopsy (SLCNB) has been shown to be as effective in diagnosing these lesions as diagnostic surgical excision, and has become the preferred diagnostic

  7. The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

    International Nuclear Information System (INIS)

    Brunner, Andreas H; Sagmeister, Thomas; Kremer, Jolanta; Riss, Paul; Brustmann, Hermann

    2009-01-01

    Limited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast. In a retrospective analysis data of 120 consecutive handheldultrasound- guided 14- gauge automated core needle biopsies (CNB) in 109 consecutive patients with breast lesions between 2006 and 2007 were evaluated. In our outpatient clinic120 CNB were performed. In 59/120 (49.2%) cases we compared histological diagnosis on frozen sections with those on paraffin sections of CNB and finally with the result of open biopsy. Of the cases 42/59 (71.2%) were proved to be malignant and 17/59 (28.8%) to be benign in the definitive histology. 2/59 (3.3%) biopsies had a false negative frozen section result. No false positive results of the intraoperative frozen section analysis were obtained, resulting in a sensitivity, specificity and positive predicting value (PPV) and negative predicting value (NPV) of 95%, 100%, 100% and 90%, respectively. Histological and morphobiological parameters did not show up relevance for correct frozen section analysis. In cases of malignancy time between diagnosis and definitive treatment could not be reduced due to frozen section analysis. The frozen section analysis of suspect breast lesions performed by CNB displays good sensitivity/specificity characteristics. Immediate investigations of CNB is an accurate diagnostic tool and an important step in reducing psychological strain by minimizing the period of uncertainty in patients with breast tumor

  8. Performance of a New Blunt-Tip Coaxial Needle for Percutaneous Biopsy and Drainage of "Hard-To-Reach" Targets.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Caudrelier, Jean; Bauones, Salem; Tsoumakidou, Georgia; Koch, Guillaume; Gangi, Afshin

    2017-09-01

    To present a new blunt-tip coaxial needle (SoftGuard) applied to access "hard-to-reach" targets undergoing percutaneous image-guided biopsy or drainage. All consecutive patients presenting between August and December 2016 with "hard-to-reach" (blunt-tip needle is a safe and effective tool when applied as a coaxial working cannula for percutaneous biopsy or drainage of "hard-to-reach" targets.

  9. Simple localization of peripheral pulmonary nodules - CT-guided percutaneous hook-wire localization

    International Nuclear Information System (INIS)

    Poretti, F.P.; Vorwerk, D.; Brunner, E.

    2002-01-01

    Background: Video-assisted thoracoscopic surgery (VATS) is an alternative approach to small intrapulmonary nodules, if transbronchial or percutaneous biopsy have failed. We investigated the feasibility and effectiveness of the percutaneous CT-guided placement of hook-wires to localize such nodules before video-assisted thoracoscopy. Subjects and Methods: 19 patients with new by diagnosed intrapulmonary nodules underwent CT-guided hook-wire localization by application of a X-Reidy-Set (Cook, Inc., Bjaeverskov, Denmark). The average age of the patient was 63 years (range: 19-80 years), the mean distance between the nodule and the pleura visceral was 7.58 mm (range: 0-25 mm) and the mean diameter was 11.58 mm (range: 5-25 mm). After localization, the patients underwent a VATS resection of the lesion within a mean time of 30 min (range 10-48 min). Results: In all cases, resection of the nodules was successful. In 4 older patients the marking was complicated by poor cooperability. At the end of manipulation the end of the hook was distanced from the nodule. But also in these cases, resection was successfully performed. 8 patients developed an asymptomatic pneumothorax: 5 of them in a minor (max. 1.5 cm rim), three of them in a moderate (max. 3 cm rim) dimension. In 4 patients, in whom the tumor was hit directly by the needle, local bleeding occurred. In one case, haemoptoe was present. In no patient did a dislocation of the hookwire-system occur. Conclusion: CT-guided placement of a hook-wire system is a simple and reasonable procedure which facilitates safe VATS resection of small pulmonary nodules. (orig.) [de

  10. Needle aspiration biopsy in the diagnosis of lytic bone lesions in histiocytosis X, Ewing's sarcoma and neuroblastoma

    International Nuclear Information System (INIS)

    Thommesen, P.; Frederiksen, P.; Loewhagen, T.; Willems, J.S.

    1978-01-01

    Cytologic smears obtained by needle aspiration biopsy of lytic bone lesions in 15 patients with histiocytosis X, Ewing's sarcoma and neuroblastoma were reviewed. After conventional staining, histiocytosis X could be diagnosed and differentiated from small cell tumours such as Ewing's sarcoma and neuroblastoma. The need for sampling material for cytochemical and ultrastructural analysis of these small cell tumours by needle aspiration is emphasized. (Auth.)

  11. Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material

    International Nuclear Information System (INIS)

    Degirmenci, B.; Haktanir, A.; Albayrak, R.; Acar, M.; Sahin, D.A.; Sahin, O.; Yucel, A.; Caliskan, G.

    2007-01-01

    Aim: To evaluate the effects of sonographic characteristics of thyroid nodules, the diameter of needle used for sampling, and sampling technique on obtaining sufficient cytological material (SCM). Materials and methods: We performed sonography-guided fine-needle biopsy (FNB) in 232 solid thyroid nodules. Size-, echogenicity, vascularity, and localization of all nodules were evaluated by Doppler sonography before the biopsy. Needles of size 20, 22, and 24 G were used for biopsy. The biopsy specimen was acquired using two different methods after localisation. In first method, the needle tip was advanced into the nodule in various positions using a to-and-fro motion whilst in the nodule, along with concurrent aspiration. In the second method, the needle was advanced vigorously using a to-and-fro motion within the nodule whilst being rotated on its axis (capillary-action technique). Results: The mean nodule size was 2.1 ± 1.3 cm (range 0.4-7.2 cm). SCM was acquired from 154 (66.4%) nodules by sonography-guided FNB. In 78 (33.6%) nodules, SCM could not be collected. There was no significant difference between nodules with different echogenicity and vascularity for SCM. Regarding the needle size, the lowest rate of SCM was obtained using 20 G needles (56.6%) and the highest rate of adequate material was obtained using 24 G needles (82.5%; p = 0.001). The SCM rate was 76.9% with the capillary-action technique versus 49.4% with the aspiration technique (p < 0.001). Conclusion: Selecting finer needles (24-25 G) for sonography-guided FNB of thyroid nodules and using the capillary-action technique decreased the rate of inadequate material in cytological examination

  12. New radiofrequency device to reduce bleeding after core needle biopsy: Experimental study in a porcine liver model

    International Nuclear Information System (INIS)

    Lim, Sang Hyeok; Rhim, Hyun Chul; Lee, Min Woo; Song, Kyoung Doo; Kang, Tae Wook; Kim, Young Sun; Lim, Hyo Keun

    2017-01-01

    To evaluate the in vivo efficiency of the biopsy tract radiofrequency ablation for hemostasis after core biopsy of the liver in a porcine liver model, including situations with bleeding tendency and a larger (16-gauge) core needle. A preliminary study was performed using one pig to determine optimal ablation parameters. For the main experiment, four pigs were assigned to different groups according to heparinization use and biopsy needle caliber. In each pig, 14 control (without tract ablation) and 14 experimental (tract ablation) ultrasound-guided core biopsies were performed using either an 18- or 16-gauge needle. Post-biopsy bleeding amounts were measured by soaking up the blood for five minutes. The results were compared using the Mann-Whitney U test. The optimal parameters for biopsy tract ablation were determined as a 2-cm active tip electrode set at 40-watt with a tip temperature of 70–80℃. The bleeding amounts in all experimental groups were smaller than those in the controls; however they were significant in the non-heparinized pig biopsied with an 18-gauge needle and in two heparinized pigs (p < 0.001). In the heparinized pigs, the mean blood loss in the experimental group was 3.5% and 13.5% of the controls biopsied with an 18- and 16-gauge needle, respectively. Radiofrequency ablation of hepatic core biopsy tract ablation may reduce post-biopsy bleeding even under bleeding tendency and using a larger core needle, according to the result from in vivo porcine model experiments

  13. New radiofrequency device to reduce bleeding after core needle biopsy: Experimental study in a porcine liver model

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Hyeok; Rhim, Hyun Chul; Lee, Min Woo; Song, Kyoung Doo; Kang, Tae Wook; Kim, Young Sun; Lim, Hyo Keun [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-01-15

    To evaluate the in vivo efficiency of the biopsy tract radiofrequency ablation for hemostasis after core biopsy of the liver in a porcine liver model, including situations with bleeding tendency and a larger (16-gauge) core needle. A preliminary study was performed using one pig to determine optimal ablation parameters. For the main experiment, four pigs were assigned to different groups according to heparinization use and biopsy needle caliber. In each pig, 14 control (without tract ablation) and 14 experimental (tract ablation) ultrasound-guided core biopsies were performed using either an 18- or 16-gauge needle. Post-biopsy bleeding amounts were measured by soaking up the blood for five minutes. The results were compared using the Mann-Whitney U test. The optimal parameters for biopsy tract ablation were determined as a 2-cm active tip electrode set at 40-watt with a tip temperature of 70–80℃. The bleeding amounts in all experimental groups were smaller than those in the controls; however they were significant in the non-heparinized pig biopsied with an 18-gauge needle and in two heparinized pigs (p < 0.001). In the heparinized pigs, the mean blood loss in the experimental group was 3.5% and 13.5% of the controls biopsied with an 18- and 16-gauge needle, respectively. Radiofrequency ablation of hepatic core biopsy tract ablation may reduce post-biopsy bleeding even under bleeding tendency and using a larger core needle, according to the result from in vivo porcine model experiments.

  14. Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in the diagnosis of breast lesions.

    Science.gov (United States)

    Moschetta, M; Telegrafo, M; Carluccio, D A; Jablonska, J P; Rella, L; Serio, Gabriella; Carrozzo, M; Stabile Ianora, A A; Angelelli, G

    2014-01-01

    To compare the diagnostic accuracy of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients with USdetected breast lesions. Between September 2011 and May 2013, 3469 consecutive breast US examinations were performed. 400 breast nodules were detected in 398 patients. 210 FNACs and 190 CNBs were performed. 183 out of 400 (46%) lesions were surgically removed within 30 days form diagnosis; in the remaining cases, a six month follow up US examination was performed. Sensitivity, specificity, diagnostic accuracy, positive predictive (PPV) and negative predictive (NPV) values were calculated for FNAC and CNB. 174 out of 400 (43%) malignant lesions were found while the remaining 226 resulted to be benign lesions. 166 out of 210 (79%) FNACs and 154 out of 190 (81%) CNBs provided diagnostic specimens. Sensitivity, specificity, diagnostic accuracy, PPV and NPV of 97%, 94%, 95%, 91% and 98% were found for FNAC, and values of 92%, 82%, 89%, 92% and 82% were obtained for CNB. Sensitivity, specificity, diagnostic accuracy, PPV and NPV of 97%, 96%, 96%, 97% and 96% were found for FNAC, and values of 97%, 96%, 96%, 97% and 96% were obtained for CNB. FNAC and CNB provide similar values of diagnostic accuracy.

  15. Vacuum-assisted breast biopsy: A comparison of 11-gauge and 8-gauge needles in benign breast disease

    Directory of Open Access Journals (Sweden)

    Kraemer Bernhard

    2008-05-01

    Full Text Available Abstract Background Minimal invasive breast biopsy is standard care for the diagnosis of suspicious breast lesions. There are different vacuum biopsy (VB systems in use. The aim of the study was to determine the differences between the 8-gauge and the 11-gauge needle with respect to a diagnostic reliability, b complication rate and c subjective perception of pain when used for vacuum-assisted breast biopsy. Methods Between 01/2000 and 09/2004, 923 patients at St. Josefs-Hospital Wiesbaden underwent VB using the Mammotome® (Ethicon Endosurgery, Hamburg. Depending on preoperative detection, the procedure was performed under sonographic or mammographic guidance under local anaesthesia. All patients included in the study were followed up both clinically and using imaging techniques one week after the VB and a second time after a median of 41 months. Excisional biopsy on the ipsilateral breast was an exclusion criteria. Subjective pain scores were recorded on a scale of 0 – 10 (0 = no pain, 10 = unbearable pain. The mean age of the patients was 53 years (30 – 88. Results 123 patients were included in the study in total. 48 patients were biopsied with the 8-gauge needle and 75 with the 11-gauge needle. The use of the 8-gauge needle did not show any significant differences to the 11-gauge needle with regard to diagnostic reliability, complication rate and subjective perception of pain. Conclusion Our data show that there are no relevant differences between the 8-gauge and 11-gauge needle when used for VB. Under sonographic guidance, the use of the 8-gauge needle is recommended for firm breast tissue due to its sharp scalpel point and especially for complete removal of benign lesions. We did not find any advantages in the use of the larger 8-gauge needle compared to the 11-gauge needle in the mammography setting. The utilisation costs of the 8-gauge needle are somewhat higher.

  16. Confocal Microscopy of Unfixed Breast Needle Core Biopsies: A Comparison to Fixed and Stained Sections

    Directory of Open Access Journals (Sweden)

    Zavislan James M

    2009-08-01

    Full Text Available Abstract Background Needle core biopsy, often in conjunction with ultrasonic or stereotactic guided techniques, is frequently used to diagnose breast carcinoma in women. Confocal scanning laser microscopy (CSLM is a technology that provides real-time digital images of tissues with cellular resolution. This paper reports the progress in developing techniques to rapidly screen needle core breast biopsy and surgical specimens at the point of care. CSLM requires minimal tissue processing and has the potential to reduce the time from excision to diagnosis. Following imaging, specimens can still be submitted for standard histopathological preparation. Methods Needle core breast specimens from 49 patients were imaged at the time of biopsy. These lesions had been characterized under the Breast Imaging Reporting And Data System (BI-RADS as category 3, 4 or 5. The core biopsies were imaged with the CSLM before fixation. Samples were treated with 5% citric acid and glycerin USP to enhance nuclear visibility in the reflectance confocal images. Immediately following imaging, the specimens were fixed in buffered formalin and submitted for histological processing and pathological diagnosis. CSLM images were then compared to the standard histology. Results The pathologic diagnoses by standard histology were 7 invasive ductal carcinomas, 2 invasive lobular carcinomas, 3 ductal carcinomas in-situ (CIS, 21 fibrocystic changes/proliferative conditions, 9 fibroadenomas, and 5 other/benign; two were excluded due to imaging difficulties. Morphologic and cellular features of benign and cancerous lesions were identified in the confocal images and were comparable to standard histologic sections of the same tissue. Conclusion CSLM is a technique with the potential to screen needle core biopsy specimens in real-time. The confocal images contained sufficient information to identify stromal reactions such as fibrosis and cellular proliferations such as intra-ductal and

  17. Confocal Microscopy of Unfixed Breast Needle Core Biopsies: A Comparison to Fixed and Stained Sections

    Science.gov (United States)

    2009-01-01

    Background Needle core biopsy, often in conjunction with ultrasonic or stereotactic guided techniques, is frequently used to diagnose breast carcinoma in women. Confocal scanning laser microscopy (CSLM) is a technology that provides real-time digital images of tissues with cellular resolution. This paper reports the progress in developing techniques to rapidly screen needle core breast biopsy and surgical specimens at the point of care. CSLM requires minimal tissue processing and has the potential to reduce the time from excision to diagnosis. Following imaging, specimens can still be submitted for standard histopathological preparation. Methods Needle core breast specimens from 49 patients were imaged at the time of biopsy. These lesions had been characterized under the Breast Imaging Reporting And Data System (BI-RADS) as category 3, 4 or 5. The core biopsies were imaged with the CSLM before fixation. Samples were treated with 5% citric acid and glycerin USP to enhance nuclear visibility in the reflectance confocal images. Immediately following imaging, the specimens were fixed in buffered formalin and submitted for histological processing and pathological diagnosis. CSLM images were then compared to the standard histology. Results The pathologic diagnoses by standard histology were 7 invasive ductal carcinomas, 2 invasive lobular carcinomas, 3 ductal carcinomas in-situ (CIS), 21 fibrocystic changes/proliferative conditions, 9 fibroadenomas, and 5 other/benign; two were excluded due to imaging difficulties. Morphologic and cellular features of benign and cancerous lesions were identified in the confocal images and were comparable to standard histologic sections of the same tissue. Conclusion CSLM is a technique with the potential to screen needle core biopsy specimens in real-time. The confocal images contained sufficient information to identify stromal reactions such as fibrosis and cellular proliferations such as intra-ductal and infiltrating carcinoma, and

  18. 78 FR 66932 - Scientific Information Request on Core Needle and Open Surgical Biopsy for Diagnosis of Breast...

    Science.gov (United States)

    2013-11-07

    ... is women who have been referred for biopsy for the diagnosis of primary breast cancer (including... diagnosis of breast cancer) are excluded. Comparators (Reference Standard and Comparator Index Tests) For... Information Request on Core Needle and Open Surgical Biopsy for Diagnosis of Breast Lesions AGENCY: Agency for...

  19. Clinical background and its relation to results of percutaneous needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy

    International Nuclear Information System (INIS)

    Aoki, Jun; Koyama, Yoshinori; Morita, Hideo; Takahashi, Ayako; Nakajima, Takahito; Yagi, Akiko; Arai, Kiyokazu; Shinozaki, Tetsuya; Watanabe, Hideomi

    2005-01-01

    The purpose of this study was to investigate the clinical background of needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy. During a 3-year period (from April 2000 to March 2003), 103 needle biopsies on 101 lesions of 90 patients were performed for pathological evaluation of suspected bone metastasis. The clinical course of these patients prior to biopsy and its relation to the biopsy results were retrospectively reviewed. Sixty-two patients (69% of total cases) were referred for biopsy from orthopedic surgeons, and 51 of these patients consulted orthopedic surgeons on the initial presentation. Malignancy was pathologically proved in 47 (76%) of the 62 orthopedic patients, and in 19 (68%) of the 28 patients referred from other clinicians. Thirteen (21%) of the orthopedic patients had a history of malignancy, while 22 (78%) of the non-orthopedic patients were cancer patients. Metastasis was pathologically proved in 23 (66%) of the 35 patients with a history of malignancy, while malignancy was pathologically proved in 43 (78%) of the 55 patients without known malignancy. Diagnostic accuracy of the needle bone biopsy was 96%, and its complication rate was 0.7%. In the era of CT fluoroscopy, needle biopsy for suspected bone metastasis was most frequently requested for the patients who consulted orthopedic surgeons for the occurrence of local bone pain as the initial symptom of unknown malignancy. Frequency of malignancy proved by the biopsy in those patients was as high as that in the cancer patients referred from other clinicians. (author)

  20. The diagnostic value of ultrasound-guided fine-needle aspiration biopsy in breast masses

    International Nuclear Information System (INIS)

    Lee, Nam Hee; Lim, Hyun Yang; Park, Noh Kyong; Tae, Seok; Shin, Kyung Ja; Lee, Sang Chun

    1993-01-01

    Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three groups and aspirates were categorized into three cytologic groups. The cytologic results was reported benign masses (cytologic group 1) in 71 cases (52%). malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 case (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benign masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer

  1. Fine needle aspiration biopsy diagnosis of metastatic neoplasms of the breast. A three-case report

    Directory of Open Access Journals (Sweden)

    Raquel Garza-Guajardo

    2005-09-01

    Full Text Available Abstract Metastases to the breast are unusual lesions that make up approximately 2% of all malignant mammary neoplasms and may mimic both benign and malignant primary neoplasms from a clinical point of view, as well as in imaging studies. Arriving at a correct diagnosis is therefore essential in order to establish appropriate management. We present three cases of metastatic neoplasms diagnosed through fine needle aspiration biopsy and immunocytochemistry. The cytological diagnoses were: medulloblastoma in an 18-year-old woman, melanoma in a 26-year-old man, and an exceptional case of ovarian sarcoma originating from a granulosa cell tumor with metastases to both breasts. A metastatic disease should be considered in the differential diagnosis of a palpable mass in the breast, especially if there is a history of an extramammary malignant neoplasm. Fine needle aspiration biopsy is the method of choice for the management of these cases. Whenever possible the exam of the material obtained should be compared to the previous biopsy, which is usually enough to arrive at a correct diagnosis, thus preventing unnecessary surgical procedures.

  2. The diagnostic value of ultrasound-guided fine-needle aspiration biopsy in breast masses

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Hee; Lim, Hyun Yang; Park, Noh Kyong; Tae, Seok; Shin, Kyung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1993-05-15

    Real-time ultrasound-guided fine-needle aspiration biopsy in 137 solid breast masses was performed. Sonographic findings were categorized into three groups and aspirates were categorized into three cytologic groups. The cytologic results was reported benign masses (cytologic group 1) in 71 cases (52%). malignant masses (cytologic group 2 and 3) in 44 cases (32%) and insufficient specimens in 22 case (16%). Insufficient specimens were treated as benign masses. Excisional biopsy in 44 malignant masses and 3 benign masses according to cytologic results, clinical findings and follow up study was performed. The result was reported 41 malignant masses and 6 benign masses. Based on cytologic criteria, sensitivity for detection of malignancy was 93% and specificity was 94%. In conclusion, the high specificity provided by ultrasound-guided fine-needle aspiration biopsy could markedly reduce unnecessary surgical excisions for benign masses and it should be routinely performed, since it can give physical and emotional benefits to patients and lead to earlier and cost effective diagnosis of breast cancer.

  3. Microscopic findings in EUS-guided fine needle (SharkCore) biopsies with type 1 and type 2 autoimmune pancreatitis

    DEFF Research Database (Denmark)

    Detlefsen, Sönke; Joergensen, Maiken Thyregod; Mortensen, Michael Bau

    2017-01-01

    The International Consensus Diagnostic Criteria (ICDC) for the diagnosis of autoimmune pancreatitis (AIP) include the histological criterion that is based on either pancreatic core needle biopsies (CNBs) or surgical specimens. However, CNBs are difficult to obtain by endoscopic ultrasound (EUS......). EUS fine-needle aspiration (EUS-FNA) cytology is usually not sufficient for the diagnosis of AIP, but may sometimes contain tissue microfragments. Another approach is EUS-guided histological fine-needle biopsy (EUS-FNB), using needles such as the SharkCore or ProCore needle. Published data regarding...... EUS-guided SharkCore FNB for the diagnosis of AIP are lacking. We aimed to describe our histological findings in one type 1 and two type 2 AIP patients who underwent EUS SharkCore FNB. The EUS-FNBs of two patients fulfilled the histological level 2 ICDC for type 1 AIP or type 2 AIP. The EUS-FNB of one...

  4. Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

    International Nuclear Information System (INIS)

    Kang, Yun Dan; Kim, You Me

    2016-01-01

    The purpose of this study was to compare needle aspiration and vacuum-assisted biopsy in the ultrasound-guided treatment of lactational breast abscesses. Between January 2005 and December 2014, a total of 74 patients presented with lactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated with needle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student's t test and the chi-square test were used to compare the variables. No significant difference was found in the cure rate between the needle aspiration group (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001). Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses

  5. Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yun Dan; Kim, You Me [Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2016-03-15

    The purpose of this study was to compare needle aspiration and vacuum-assisted biopsy in the ultrasound-guided treatment of lactational breast abscesses. Between January 2005 and December 2014, a total of 74 patients presented with lactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated with needle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student's t test and the chi-square test were used to compare the variables. No significant difference was found in the cure rate between the needle aspiration group (22/25, 88%) and the vacuum-assisted biopsy group (18/19, 94.7%) (P=0.441). However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days) than in the needle aspiration group (9.0 days) (P=0.001). Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.

  6. Can EGFR mutation status be reliably determined in pre-operative needle biopsies from adenocarcinomas of the lung?

    DEFF Research Database (Denmark)

    Lindahl, Kim Hein; Sørensen, Flemming Brandt; Jonstrup, Søren Peter

    2015-01-01

    The identification of EGFR mutations in non-small-cell lung cancer is important for selecting patients, who may benefit from treatment with EGFR tyrosine kinase inhibitors. The analysis is usually performed on cytological aspirates and/or histological needle biopsies, representing a small fraction....... Moreover, several inconclusive results in the diagnostic biopsies reveal that attention must be paid on the suitability of pre-operative biopsies for EGFR mutation analysis....

  7. Use of percutaneous image-guided coaxial core-needle biopsy for diagnosis of intraabdominal lymphoma

    International Nuclear Information System (INIS)

    Shimizu, Ikuo; Okazaki, Yoichi; Takeda, Wataru; Kirihara, Takehiko; Sato, Keijiro; Fujikawa, Yuko; Ueki, Toshimitsu; Hiroshima, Yuki; Sumi, Masahiko; Ueno, Mayumi; Ichikawa, Naoaki; Kobayashi, Hikaru

    2014-01-01

    Although pathological diagnosis is essential for managing malignant lymphoma, intraabdominal lesions are generally difficult to approach due to the invasiveness of abdominal surgery. Here, we report the use of percutaneous image-guided coaxial core-needle biopsy (CNB) to obtain intraabdominal specimens for diagnosing intraabdominal lymphomas, which typically requires histopathological and immunohistochemical evaluation. We retrospectively reviewed consecutive cases involving computed tomography (CT)- or ultrasonography (US)-guided CNB to obtain pathological specimens for intraabdominal lesions from 1999 to 2011. Liver, spleen, kidney, and inguinal node biopsies were excluded. We compared CNBs with laparotomic biopsies. A total of 66 CNBs were performed for 59 patients (32 males, 27 females; median age, 63.5), including second or third repeat procedures. Overall diagnostic rate was 88.5%. None of the patients required additional surgical biopsies. Notably, the median interval between recognition of an intraabdominal mass and biopsy was only 1 day. Forty-five procedures were performed for hematological malignancies. Adequate specimens were obtained for histopathological diagnosis in 86% of cases. Flow cytometry detected lymphoma cells in 79.5% of cases. Twelve patients (nine males, three females; median age, 60) were eligible for surgical biopsy. While every postoperative course was satisfactory, median duration from lesion recognition to therapy initiation for lymphoma cases was significantly shorter for CNB than for surgical biopsy (14 vs. 35 days). While one-fourth of the patients were not eligible for the procedures, CNB is safe and highly effective for diagnosis of intraabdominal lymphomas. This method significantly improves sampling and potentially helps attain immunohistological distinction, allowing for more timely therapy initiation

  8. Image-guided automated needle biopsy of 106 thoracic lesions: a retrospective review of diagnostic accuracy and complication rates

    International Nuclear Information System (INIS)

    Connor, S.; Dyer, J.; Guest, P.

    2000-01-01

    We reviewed the diagnostic accuracy and complication rates of transthoracic needle biopsy (TNB) with an automated 18-gauge core biopsy needle and gun, using either fluoroscopic or CT guidance. One hundred six lesions were biopsied in 103 patients between 1992 and 1998. Hard-copy images, imaging reports, pathology reports and clinical notes were reviewed. In 3 patients it was not possible to establish the lesion as either malignant or benign from the available follow-up, so these were removed from the analysis of diagnostic accuracy. Adequate samples for histological diagnosis were obtained in 104 of 106 (98 %) biopsies. There were 75 of 85 (88 %) true-positive core biopsies for malignant lesions and a specific cell type was identified in 70 of 85 (82 %) cases. A specific histological diagnosis was obtained in 12 of 18 (66 %) biopsies. There was a 19 % rate of pneumothorax with only 2.4 % requiring drainage. Minor haemoptysis occurred in 3.8 % of procedures. The TNB technique with an automated core biopsy needle provides a high level of diagnostic accuracy, effectively distinguishes cell type in malignancy and provides a definite diagnosis in benign disease more frequently than fine needle aspiration (FNA). There is no increased complication rate compared with FNA. (orig.)

  9. Cavernous sinus lesions biopsy with neuronavigation and tip-cut needle

    Science.gov (United States)

    Lorenzetti, Martin; Carvalho, Herculano; Cattoni, Maria; Gonçalves-Ferreira, Antonio; Pimentel, José; Antuñes, Joao

    2014-01-01

    Background: Transoval biopsy of cavernous sinus (CS) lesions is the last non-invasive diagnostic option in those 15% of patients in whom etiology remains unclear in spite of extensive neuroradiological imaging, clinical assessment, and laboratory evaluation. However, there are no guidelines defining indications and the most appropriate technique for this procedure. Case Description: We present four patients in whom we performed X-ray and neuronavigation-assisted transoval CS biopsies using tip-cut needles. Conclusion: The technique described allows the operator to determine the optimal angle for entering the CS, avoiding the complications due to distorted anatomy, and facilitating orientation once inside the CS. It reduces both radiation exposure as well as general anesthesia duration. PMID:25593783

  10. Cutting needle biopsy combined with immunohistochemical study of myeloperoxidase for the diagnosis of histiocytic necrotizing lymphadenitis.

    Science.gov (United States)

    Hanakawa, Hiroyuki; Orita, Yorihisa; Sato, Yasuharu; Takeuchi, Mai; Ohno, Kyotaro; Iwaki, Noriko; Ito, Toshihiro; Nishizaki, Kazunori; Yoshino, Tadashi

    2013-12-01

    Cutting needle biopsy (CNB) combined with immunohistochemical study of myeloperoxidase (MPO) is a useful minimally invasive diagnostic procedure for histiocytic necrotizing lymphadenitis (HNL). HNL is mainly diagnosed by pathological findings of open surgical biopsy (OSB) specimens. Recently the appearance of anti-MPO positive histiocytes has been reported as a highly specific pathological diagnosis for HNL. Considering the cosmetic impact and burden on the patients, we performed CNB combined with immunohistochemical study of MPO for the diagnosis of HNL. Few studies have reported the utility of this method in the diagnosis of HNL. A retrospective study was conducted using clinical data from 20 HNL patients. CNB was performed in 8 patients and OSB in 13 (OSB after CNB in 1). MPO-positive histiocytes were observed in all of the 20 cases. The accuracy of the diagnoses was finally confirmed by the clinical courses in all cases.

  11. Thyroid nodules with isolated macrocalcification: Malignancy and diagnostic efficacy of fine-needle aspiration and core needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin [Dept. of Radiology, Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Ryoo, Jae Wook [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jung, So Lyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-07-15

    This study was performed to determine the malignancy risk of thyroid nodules with isolated macrocalcification and to evaluate the diagnostic efficacy of fine-needle aspiration (FNA) and core needle biopsy (CNB). From May 2008 to December 2014, a total of 44 patients with isolated macrocalcifications were enrolled from 4,081 consecutive patients who underwent FNA or CNB at a single institution. We assessed the malignancy risk of nodules with isolated macrocalcification. We compared the diagnostic results between FNA and CNB, and the diagnostic efficacy of each procedure was evaluated by the rate of inconclusive results. We compared the diagnostic performance for malignancy between FNA and CNB with a criterion of malignant or atypia/follicular lesion of undetermined significance (indeterminate) diagnostic results. We investigated whether the ultrasonographic feature of isolated macrocalcification was predictive of malignancy. The malignancy risk of nodules with isolated macrocalcification was 16.1% in 31 nodules with final diagnoses and 11.4% in all nodules. CNB demonstrated a significantly lower rate of nondiagnostic and inconclusive results than FNA (7.7% vs. 53.8%, P=0.002 and 15.4% vs. 57.7%, P=0.003, respectively) in 26 nodules that underwent both FNA and CNB. CNB showed a marginally higher diagnostic performance for identifying malignancy than FNA (P=0.067). The ultrasonographic features of the anterior margin of isolated macrocalcification were not predictive of malignancy (P>0.999). Thyroid nodules with isolated macrocalcification had a low to intermediate malignancy risk and should not be considered benign nodules. CNB showed a higher diagnostic efficacy than FNA in these nodules.

  12. Thyroid nodules with isolated macrocalcification: Malignancy and diagnostic efficacy of fine-needle aspiration and core needle biopsy

    International Nuclear Information System (INIS)

    Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin; Ryoo, Jae Wook; Jung, So Lyung

    2016-01-01

    This study was performed to determine the malignancy risk of thyroid nodules with isolated macrocalcification and to evaluate the diagnostic efficacy of fine-needle aspiration (FNA) and core needle biopsy (CNB). From May 2008 to December 2014, a total of 44 patients with isolated macrocalcifications were enrolled from 4,081 consecutive patients who underwent FNA or CNB at a single institution. We assessed the malignancy risk of nodules with isolated macrocalcification. We compared the diagnostic results between FNA and CNB, and the diagnostic efficacy of each procedure was evaluated by the rate of inconclusive results. We compared the diagnostic performance for malignancy between FNA and CNB with a criterion of malignant or atypia/follicular lesion of undetermined significance (indeterminate) diagnostic results. We investigated whether the ultrasonographic feature of isolated macrocalcification was predictive of malignancy. The malignancy risk of nodules with isolated macrocalcification was 16.1% in 31 nodules with final diagnoses and 11.4% in all nodules. CNB demonstrated a significantly lower rate of nondiagnostic and inconclusive results than FNA (7.7% vs. 53.8%, P=0.002 and 15.4% vs. 57.7%, P=0.003, respectively) in 26 nodules that underwent both FNA and CNB. CNB showed a marginally higher diagnostic performance for identifying malignancy than FNA (P=0.067). The ultrasonographic features of the anterior margin of isolated macrocalcification were not predictive of malignancy (P>0.999). Thyroid nodules with isolated macrocalcification had a low to intermediate malignancy risk and should not be considered benign nodules. CNB showed a higher diagnostic efficacy than FNA in these nodules

  13. Computed tomography guidance for skeletal biopsy

    International Nuclear Information System (INIS)

    Frager, D.H.; Goldman, M.J.; Elkin, C.M.; Cynamon, J.; Leeds, N.E.; Seimon, L.P.; Habermann, E.T.; Schreiber, K.; Freeman, L.M.

    1987-01-01

    Computed tomographic (CT) guided biopsy and abscess drainage of multiple organ systems have been well described. Reports of spinal and skeletal applications have been less common. This study describes the use of CT guidance in the biopsy of various skeletal lesions in 46 patients. Forty-one patients had skinny needle aspirations (18 or 22 gauge) and 23 patients had trephine core biopsies. Sites of the lesions included: thoracic spine - 15 patients, lumbosacral spine - 17 patients, bony pelvis - 6 patients, rib - 2 patients, and long bones - 6 patients. Fast scanners capable of rapid image reconstruction have overcome many constraints. With CT guidance, the physician who performs the procedure receives virtually no ionizing radiation. The exact location of the needle tip is accurately visualized in relation to the lesion being biopsied and to the vital organs. (orig.)

  14. [Transthoracic needle-biopsy in coin-lesions of the lung-comparison of the results of different procedures (author's transl)].

    Science.gov (United States)

    Dürschmied, H; Polak, J

    1980-01-01

    This report deals with the results and the complications of transthoracic needle-biopsy performed with different methods at two cooperating hospitals (Prague and Bad Berka). Each hospital investigated 200 persons. As for tumours thin-needle biopsy yielded more positive results for tumours also more false positive results. As for other localized lung diseases the biopsy by means of a Hauser-needle was more successful.

  15. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  16. Fibroadenoma: can fine needle aspiration biopsy avoid short term follow-up?

    Science.gov (United States)

    Leconte, I; Abraham, C; Galant, C; Sy, M; Berlière, M; Fellah, L

    2012-10-01

    To confirm whether fine needle aspiration biopsy (FNAB) can avoid close monitoring, a source of worry for women patients with a suspected fibroadenoma found by ultrasound, and requiring their compliance. Over 39months, 427 nodules with a diagnosis of fibroadenoma were sampled in 372 patients using ultrasound-guided FNAB. The sonographic appearance of all the nodules suggested BI-RADS category 3 fibroadenomas. The mean size of the fibroadenomas was 9mm. The mean duration of follow-up was 29.7months. Seven nodules had atypical cytology: a microbiopsy and/or excision found a simple fibroadenoma (n=3), mastitis (n=1), a fibroadenoma associated with a papilloma (n=1), fibrosis (n=1) and normal tissue (n=1). Seven other nodules were resected during treatment for synchronous cancer, and were diagnosed as fibroadenomas. Two hundred and seventy-six nodules were followed-up (121 patients were lost to follow-up [n=132]) and the appearance of 263 nodules (95.29%) was stable. Seven nodules, which had increased in size, underwent another FNAB or microbiopsy or surgery. Five nodules were not found again. The borders of one nodule showed modifications. The use of fine needle aspiration biopsy, interpreted by an experienced cytologist, means that short term follow-up of fibroadenomas can be avoided. Copyright © 2012 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  17. Mixed germ cell tumor of mediastinum/lung masquerading as hemangioma in fine needle biopsy

    Directory of Open Access Journals (Sweden)

    Rathna Nuti

    2013-01-01

    Full Text Available The histological predominance of one component in a germ cell tumor can lead to a mistaken diagnosis. Here, we describe a mediastinal teratoma with predominant vascular proliferation (>90% which on fine needle biopsy was diagnosed as a pulmonary hemangioma. Later, resection specimen revealed other components constituting ~4%, changing the diagnosis while illustrating theimportance of careful evaluation. A 37-year-old Caucasian male with shortness of breath, weight loss, and history of recently resolved pneumonia was diagnosed with hemangioma, after a computed tomography guided fine needle biopsy of a -16.3-cm mediastinal pulmonary mass revealed abundant benign vascular elements. Following tumor excision, ~94% of the sample exhibited predominant vascular elementsThe mass also exhibited rare focal areas of malignant epithelium in a reticular arrangement and undifferentiated pleomorphic cells associated with vascular invasion. These atypical epithelial cells were positive for CD30, pan CK, AFP, β-HCG and CD 117, thusprocuring a diagnosis of mediastinal mixed germ cell tumor. Although mixed germ cell tumors consist of various tissue types, diagnosis can be easily overlooked if one component dominates. Therefore, obtaining adequate representative neoplasm samples, and sectioning the samples thoroughly, searching for coexisting tissue types is critical for accurate diagnosis.

  18. Comparison of diagnostic quality of kidney biopsy obtained using 16g and 18g needles in patients with diffuse renal disease

    Directory of Open Access Journals (Sweden)

    Komal Arora

    2012-01-01

    Full Text Available To determine the diagnostic quality and complication rates of 16G and 18G needles in biopsy of the kidney, we performed renal biopsy using a biopsy gun under ultrasound guidance in 50 patients who were prospectively and evenly assigned to one of the two needle biopsy methods from April 2007 until May 2008. Two cores of renal biopsy specimen were obtained in each case and subjected to histopathological and immunoflourescence (IF examination. Pain associated with the procedure was assessed using a visual analog scale. The number of glomeruli retrieved using the 16G needle ranged from 0 to 30 (mean 9.42 ± 5.5 and those retrieved using 18G needle ranged from 0 to 19 (mean 7.72 ± 4.4, P <0.05. The quality of biopsy was poorer with 18G needle as compared with 16G needles because of a higher amount of fragmentation and crushing artifact. There was no difference in the compli-cation rates between the two needles (2% each. The 16G needle was associated with significantly more pain than the 18G needle. We conclude that our study demonstrates the benefit of the larger 16G needle in providing more tissue and glomeruli, which is more diagnostically useful. However, the use of 16G needle was associated with significantly more pain than the 18G needle, and may be a better compromise for diagnostic usefulness and patient acceptability.

  19. Microarray analysis in clinical oncology: pre-clinical optimization using needle core biopsies from xenograft tumors

    International Nuclear Information System (INIS)

    Goley, Elizabeth M; Anderson, Soni J; Ménard, Cynthia; Chuang, Eric; Lü, Xing; Tofilon, Philip J; Camphausen, Kevin

    2004-01-01

    DNA microarray profiling performed on clinical tissue specimens can potentially provide significant information regarding human cancer biology. Biopsy cores, the typical source of human tumor tissue, however, generally provide very small amounts of RNA (0.3–15 μg). RNA amplification is a common method used to increase the amount of material available for hybridization experiments. Using human xenograft tissue, we sought to address the following three questions: 1) is amplified RNA representative of the original RNA profile? 2) what is the minimum amount of total RNA required to perform a representative amplification? 3) are the direct and indirect methods of labeling the hybridization probe equivalent? Total RNA was extracted from human xenograft tissue and amplified using a linear amplification process. RNA was labeled and hybridized, and the resulting images yielded data that was extracted into two categories using the mAdb system: 'all genes' and 'outliers'. Scatter plots were generated for each slide and Pearson Coefficients of correlation were obtained. Results show that the amplification of 5 μg of total RNA yields a Pearson Correlation Coefficient of 0.752 (N = 6,987 genes) between the amplified and total RNA samples. We subsequently determined that amplification of 0.5 μg of total RNA generated a similar Pearson Correlation Coefficient as compared to the corresponding original RNA sample. Similarly, sixty-nine percent of total RNA outliers were detected with 5 μg of amplified starting RNA, and 55% of outliers were detected with 0.5 μg of starting RNA. However, amplification of 0.05 μg of starting RNA resulted in a loss of fidelity (Pearson Coefficient 0.669 between amplified and original samples, 44% outlier concordance). In these studies the direct or indirect methods of probe labeling yielded similar results. Finally, we examined whether RNA obtained from needle core biopsies of human tumor xenografts, amplified and indirectly

  20. CT guided puncture aspiration and sclerosing treatment of ovary cyst

    International Nuclear Information System (INIS)

    Peng Yongjun; Du Xiumei; Yuan Jinrong; Chen Chanqing

    2007-01-01

    Objective: To analyze the method and the curative effect with CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst. Method: 22 ovary cysts in 22 patients were treated with percutaneous puncture aspiration and underwent repeated sclerotherapy with 99.7% ethanol injection. Among the 22 patients, 18 patients had solitary ovary cyst and was aspirated with an 18-22G gauge aspiration needle. The amount of aspirated fluid varied from 30ml-500ml and 25%-30% cyst volume was replaced by appropriate ethanol Post treatment follow-up were achieved every 3 months. Results All the Punctures were successfully completed. During the 3 months to one year follow-up, 16 ovary cyst disappeared, 6 cysts were small over 50%, without main complication. Conclusion CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst is a treatment of choice because of its safety, low complication, and high curative effect. (authors)

  1. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Multiple Thyroid Nodules

    International Nuclear Information System (INIS)

    Kim, Ji Dae; Bae, Il Hun; Lee, Seung Young; Han, Gi Seok; Cha, Sang Hun; Kim, Sung Jin; Park, Kil Sun; Koong, Sung Soo; Lee, Ok Jun

    2006-01-01

    To standardize the number of nodules which necessitates ultrasound-guided, fine-needle, aspiration biopsy in patients who have multiple thyroid nodules with the same sonographic characteristics as each other. From February, 2002 to March, 2004, among patients whose diagnosis was confirmed by ultrasound-guided, fine-needle, aspiration biopsy, 545 nodules of 203 patients were found in sonography with more than two thyroid nodules. Each thyroid gland nodule was classified on a score from 0 to 2 points on the basis of the following 5 characteristics: internal content, margin, echogenicity, shape and calcification in sonography. When the score of all characteristics was the same, by deciding on nodules with the same sonographic characteristics and with the score of at least one characteristic being different, we divided the nodules with different sonographic characteristics in a patient. By methods such as given in the preceding descriptions, patients with multiple thyroid nodules were separated into two groups: one in which all nodules had the same sonographic characteristics and another in which nodules have at least one different sonographic characteristic. Then, each pathologic result was searched for the same case and different case in each patient group. Among the 203 patients who were diagnosed with multiple thyroid nodules in ultrasonography, 79 patients (38.9%) had nodules with the same ultrasonographic characteristics and 124 patients (61.1%) had nodules with at least one different ultrasonographic characteristic. All 79 patient's nodules with the same ultrasonographic characteristics in each patient showed the same pathologic result in all cases (100.0%) and there was no case showing a different pathologic result. Otherwise, among the 124 patient's nodules with different ultrasonographic characteristics, each patient showed the same pathologic result in 111 (89.5%) and different pathologic result in 13 (10.5%). In patients who have multiple thyroid nodules

  2. Sentinel lymph node biopsy in patients with a needle core biopsy diagnosis of ductal carcinoma in situ: is it justified?

    LENUS (Irish Health Repository)

    Doyle, B

    2012-02-01

    BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) has increased markedly with the introduction of population-based mammographic screening. DCIS is usually diagnosed non-operatively. Although sentinel lymph node biopsy (SNB) has become the standard of care for patients with invasive breast carcinoma, its use in patients with DCIS is controversial. AIM: To examine the justification for offering SNB at the time of primary surgery to patients with a needle core biopsy (NCB) diagnosis of DCIS. METHODS: A retrospective analysis was performed of 145 patients with an NCB diagnosis of DCIS who had SNB performed at the time of primary surgery. The study focused on rates of SNB positivity and underestimation of invasive carcinoma by NCB, and sought to identify factors that might predict the presence of invasive carcinoma in the excision specimen. RESULTS: 7\\/145 patients (4.8%) had a positive sentinel lymph node, four macrometastases and three micrometastases. 6\\/7 patients had invasive carcinoma in the final excision specimen. 55\\/145 patients (37.9%) with an NCB diagnosis of DCIS had invasive carcinoma in the excision specimen. The median invasive tumour size was 6 mm. A radiological mass and areas of invasion <1 mm, amounting to "at least microinvasion" on NCB were predictive of invasive carcinoma in the excision specimen. CONCLUSIONS: SNB positivity in pure DCIS is rare. In view of the high rate of underestimation of invasive carcinoma in patients with an NCB diagnosis of DCIS in this study, SNB appears justified in this group of patients.

  3. Radiation dose reduction in CT-guided sacroiliac joint injections to levels of pulsed fluoroscopy: a comparative study with technical considerations

    Directory of Open Access Journals (Sweden)

    Artner J

    2012-08-01

    Full Text Available Juraj Artner, Balkan Cakir, Heiko Reichel, Friederike LattigDepartment of Orthopaedic Surgery, University of Ulm, RKU, GermanyBackground: The sacroiliac (SI joint is frequently the primary source of low back pain. Over the past decades, a number of different SI injection techniques have been used in its diagnosis and therapy. Despite the concerns regarding exposure to radiation, image-guided injection techniques are the preferred method to achieve safe and precise intra-articular needle placement. The following study presents a comparison of radiation doses, calculated for fluoroscopy and CT-guided SI joint injections in standard and low-dose protocol and presents the technical possibility of CT-guidance with maximum radiation dose reduction to levels of fluoroscopic-guidance for a precise intra-articular injection technique.Objective: To evaluate the possibility of dose reduction in CT-guided sacroiliac joint injections to pulsed-fluoroscopy-guidance levels and to compare the doses of pulsed-fluoroscopy-, CT-guidance, and low-dose CT-guidance for intra-articular SI joint injections.Study design: Comparative study with technical considerations.Methods: A total of 30 CT-guided intra-articular SI joint injections were performed in January 2012 in a developed low-dose mode and the radiation doses were calculated. They were compared to 30 pulsed-fluoroscopy-guided SI joint injections, which were performed in the month before, and to five injections, performed in standard CT-guided biopsy mode for spinal interventions. The statistical significance was calculated with the SPSS software using the Mann–Whitney U-Test. Technical details and anatomical considerations were provided.Results: A significant dose reduction of average 94.01% was achieved using the low-dose protocol for CT-guided SI joint injections. The radiation dose could be approximated to pulsed-fluoroscopy-guidance levels.Conclusion: Radiation dose of CT-guided SI joint injections can be

  4. Computed tomographic fluoroscopy-guided transthoracic needle biopsy for diagnosis of pulmonary nodules

    International Nuclear Information System (INIS)

    Hirose, Takashi; Mori, Kiyoshi; Machida, Suguru; Tominaga, Keigo; Yokoi, Kohei; Adachi, Mitsuru

    2000-01-01

    The purpose of this study was to evaluate the usefulness of computed tomographic (CT) fluoroscopy-guided transthoracic needle biopsy (TTNB) with an 18-gauge automatic biopsy gun for the diagnosis of pulmonary nodules. Between March 1996 and January 1998, 50 patients in whom pulmonary lesions could not be diagnosed cytopathologically with fiberoptic bronchoscopy or were not clearly visualized with fluoroscopy underwent CT fluoroscopy-guided TTNB. Final pathological diagnoses were 23 lung carcinomas, five pulmonary metastases and 22 benign lesions. Sufficient tissue for analysis was obtained from 48 of the 50 lesions (96%). The overall diagnostic yield of CT fluoroscopy-guided TTNB was 90%. The sensitivity, specificity and accuracy for malignancy were 89%, 100% and 94%, respectively. In 20 of the 22 cases (91%) of benign lesions, histological analysis yielded correct and specific diagnoses. Complications occurred in 22 of the 50 cases (44%). The most common complication was pneumothorax, which occurred in 21 of the 50 cases (42%). Chest tube insertion was required in 6 (12%). Although CT fluoroscopy could not decrease the complication rate, CT fluoroscopy-guided TTNB with an automatic biopsy gun appears to be a promising technique for diagnosing pulmonary lesions, particularly benign lesions. (author)

  5. Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

    Directory of Open Access Journals (Sweden)

    Yun-Dan Kang

    2016-04-01

    Full Text Available Purpose: The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses. Methods: Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25 or vacuum-assisted biopsy (n=19. Age, duration of lactation, abscess diameter, pus culture results, the number of interventions, the healing time, and the cure rate were reviewed and compared between these two groups. The Student’s t test and the chi-square test were used to compare the variables. Results: No significant difference was found in the cure rate between the needle aspirationgroup (22/25, 88% and the vacuum-assisted biopsy group (18/19, 94.7% (P=0.441. However, the mean healing time was significantly shorter in the vacuum-assisted biopsy group (6.7 days than in the needle aspiration group (9.0 days (P=0.001. Conclusion: Vacuum-assisted biopsy is a viable option for the management of lactational breast abscesses and was found to lead to a shorter healing time than needle aspiration. However, further study is necessary to establish the clinical efficacy of vacuum-assisted biopsy in the management of lactational breast abscesses.

  6. Diagnostic Ability of Percutaneous Needle Biopsy Immediately After Radiofrequency Ablation for Malignant Lung Tumors: An Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Takaaki, E-mail: t-hasegawa@aichi-cc.jp [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Kondo, Chiaki [Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnosis (Japan); Sato, Yozo; Inaba, Yoshitaka; Yamaura, Hidekazu; Kato, Mina; Murata, Shinichi; Onoda, Yui [Aichi Cancer Center Hospital, Department of Diagnostic and Interventional Radiology (Japan); Kuroda, Hiroaki; Sakao, Yukinori [Aichi Cancer Center Hospital, Department of Thoracic Surgery (Japan); Yatabe, Yasushi [Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnosis (Japan)

    2016-08-15

    PurposeTo evaluate the safety and diagnostic ability of percutaneous needle biopsy performed immediately after lung radiofrequency ablation (RFA).Materials and MethodsFrom May 2013 to April 2014, percutaneous needle biopsy was performed immediately after RFA for 3 patients (2 men and 1 woman, aged 57–76 years) who had lung tumors measuring 1.3–2.6 cm in diameter. All patients had prior history of malignancy, and all tumors were radiologically diagnosed as malignant. Obtained specimens were pathologically classified using standard hematoxylin and eosin staining.ResultsWe completed three planned sessions of RFA followed by percutaneous needle biopsy, all of which obtained tumor tissue that could be pathologically diagnosed. Two tumors were metastatic from renal clear cell carcinoma and rectal adenocarcinoma, respectively; one tumor was primary lung adenocarcinoma. There was no death or major complication related to the procedures. Although pneumothorax occurred in two patients, these resolved without the need for aspiration or chest tube placement. Tumor seeding was not observed, but 21 months after the procedure, one case developed local tumor progression that was treated by additional RFA.ConclusionPathologic diagnosis was possible by needle biopsy immediately after RFA for lung tumors. This technique may reduce the risks and efforts of performing biopsy and RFA on separate occasions.

  7. Confocal fluorescence microscopy for rapid evaluation of invasive tumor cellularity of inflammatory breast carcinoma core needle biopsies.

    Science.gov (United States)

    Dobbs, Jessica; Krishnamurthy, Savitri; Kyrish, Matthew; Benveniste, Ana Paula; Yang, Wei; Richards-Kortum, Rebecca

    2015-01-01

    Tissue sampling is a problematic issue for inflammatory breast carcinoma, and immediate evaluation following core needle biopsy is needed to evaluate specimen adequacy. We sought to determine if confocal fluorescence microscopy provides sufficient resolution to evaluate specimen adequacy by comparing invasive tumor cellularity estimated from standard histologic images to invasive tumor cellularity estimated from confocal images of breast core needle biopsy specimens. Grayscale confocal fluorescence images of breast core needle biopsy specimens were acquired following proflavine application. A breast-dedicated pathologist evaluated invasive tumor cellularity in histologic images with hematoxylin and eosin staining and in grayscale and false-colored confocal images of cores. Agreement between cellularity estimates was quantified using a kappa coefficient. 23 cores from 23 patients with suspected inflammatory breast carcinoma were imaged. Confocal images were acquired in an average of less than 2 min per core. Invasive tumor cellularity estimated from histologic and grayscale confocal images showed moderate agreement by kappa coefficient: κ = 0.48 ± 0.09 (p confocal images require less than 2 min for acquisition and allow for evaluation of invasive tumor cellularity in breast core needle biopsy specimens with moderate agreement to histologic images. We show that confocal fluorescence microscopy can be performed immediately following specimen acquisition and could indicate the need for additional biopsies at the initial visit.

  8. Uncommon primary tumors of the orbit diagnosed by computed tomography-guided core needle biopsy: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Matushita Junior, Joao Paulo Kawaoka; Bitencourt, Almir Galvao Vieira; Amoedo, Mauricio Kauark; Barbosa, Paula Nicole Vieira; Chojniak, Rubens, E-mail: almirgvb@yahoo.com.br [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil). Dept. de Imagem; Neves, Flavia Branco Cerqueira Serra [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Div. de Oftalmologia

    2014-11-15

    Computed tomography-guided percutaneous biopsy is a safe and effective alternative method for evaluating selected intra-orbital lesions where the preoperative diagnosis is important for the therapeutic planning. The authors describe two cases of patients with uncommon primary orbital tumors whose diagnosis was obtained by means of computed tomography-guided core needle biopsy, with emphasis on the technical aspects of the procedure. (author)

  9. Transperineal Prostate Core Needle Biopsy: A Comparison of Coaxial Versus Noncoaxial Method in a Randomised Trial

    International Nuclear Information System (INIS)

    Babaei Jandaghi, Ali; Habibzadeh, Habib; Falahatkar, Siavash; Heidarzadeh, Abtin; Pourghorban, Ramin

    2016-01-01

    PurposeTo compare the procedural time and complication rate of coaxial technique with those of noncoaxial technique in transperineal prostate biopsy.Materials and MethodsTransperineal prostate biopsy with coaxial (first group, n = 120) and noncoaxial (second group, n = 120) methods was performed randomly in 240 patients. The procedural time was recorded. The level of pain experienced during the procedure was assessed on a visual analogue scale (VAS), and the rate of complications was evaluated in comparison of the two methods.ResultsThe procedural time was significantly shorter in the first group (p < 0.001). In the first group, pain occurred less frequently (p = 0.002), with a significantly lower VAS score being experienced (p < 0.002). No patient had post procedural fever. Haematuria (p = 0.029) and haemorrhage from the site of biopsy (p < 0.001) were seen less frequently in the first group. There was no significant difference in the rate of urethral haemorrhage between the two groups (p = 0.059). Urinary retention occurred less commonly in the first group (p = 0.029). No significant difference was seen in the rate of dysuria between the two groups (p = 0.078).ConclusionsTransperineal prostate biopsy using a coaxial needle is a faster and less painful method with a lower rate of complications compared with conventional noncoaxial technique.

  10. Transperineal Prostate Core Needle Biopsy: A Comparison of Coaxial Versus Noncoaxial Method in a Randomised Trial

    Energy Technology Data Exchange (ETDEWEB)

    Babaei Jandaghi, Ali [Guilan University of Medical Sciences, Department of Radiology, Poursina Hospital (Iran, Islamic Republic of); Habibzadeh, Habib; Falahatkar, Siavash [Guilan University of Medical Sciences, Urology Research Center, Razi Hospital (Iran, Islamic Republic of); Heidarzadeh, Abtin [Guilan University of Medical Sciences, Department of Community Medicine (Iran, Islamic Republic of); Pourghorban, Ramin, E-mail: ramin-p2005@yahoo.com [Shahid Beheshti University of Medical Sciences, Department of Radiology, Modarres Hospital (Iran, Islamic Republic of)

    2016-12-15

    PurposeTo compare the procedural time and complication rate of coaxial technique with those of noncoaxial technique in transperineal prostate biopsy.Materials and MethodsTransperineal prostate biopsy with coaxial (first group, n = 120) and noncoaxial (second group, n = 120) methods was performed randomly in 240 patients. The procedural time was recorded. The level of pain experienced during the procedure was assessed on a visual analogue scale (VAS), and the rate of complications was evaluated in comparison of the two methods.ResultsThe procedural time was significantly shorter in the first group (p < 0.001). In the first group, pain occurred less frequently (p = 0.002), with a significantly lower VAS score being experienced (p < 0.002). No patient had post procedural fever. Haematuria (p = 0.029) and haemorrhage from the site of biopsy (p < 0.001) were seen less frequently in the first group. There was no significant difference in the rate of urethral haemorrhage between the two groups (p = 0.059). Urinary retention occurred less commonly in the first group (p = 0.029). No significant difference was seen in the rate of dysuria between the two groups (p = 0.078).ConclusionsTransperineal prostate biopsy using a coaxial needle is a faster and less painful method with a lower rate of complications compared with conventional noncoaxial technique.

  11. Intraductal Carcinoma of the Prostate on Diagnostic Needle Biopsy Predicts Prostate Cancer Mortality: A Population-Based Study.

    Science.gov (United States)

    Saeter, Thorstein; Vlatkovic, Ljiljana; Waaler, Gudmund; Servoll, Einar; Nesland, Jahn M; Axcrona, Karol; Axcrona, Ulrika

    2017-06-01

    Intraductal carcinoma of the prostate (IDC-P) is a distinct histopathologic feature associated with high-grade, advanced prostate cancer. Although studies have shown that IDC-P is a predictor of progression following surgical or radiation treatment for prostate cancer, there are sparse data regarding IDC-P on diagnostic needle biopsy as a prognosticator of prostate cancer mortality. This was a population-based study of all prostate cancer patients diagnosed using needle biopsy and without evidence of systemic disease between 1991 and 1999 within a defined geographic region of Norway. Patients were identified by cross-referencing the Norwegian Cancer Registry. Of 318 eligible patients, 283 had biopsy specimens available for central pathology review. Clinical data were obtained from medical charts. We examined whether IDC-P on diagnostic needle biopsy was associated with adverse clinicopathological features and prostate cancer mortality. Patients with IDC-P on diagnostic needle biopsy had a more advanced stage and a higher Gleason score compared to patients without IDC-P. IDC-P was also associated with an intensively reactive stroma. The 10-year prostate cancer-specific survival was 69% for patients with IDC-P on diagnostic needle biopsy and 89% for patients without IDC-P (Log rank P-value prostate cancer mortality after adjustments for clinical prognostic factors and treatment. After adjustment for the newly implemented Grade Group system of prostate cancer, IDC-P showed a strong tendency toward statistical significance. However, IDC-P did not remain a statistically significant predictor in the multivariable analysis. IDC-P on diagnostic needle biopsy is an indicator of prostate cancer with a high risk of mortality. Accordingly, a diagnosis of IDC-P on needle biopsy should be reported and considered a feature of high-risk prostate cancer. Moreover, the association between IDC-P and reactive stroma provides evidence in support of the idea that stromal factors

  12. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

    International Nuclear Information System (INIS)

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens

    2014-01-01

    Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

  13. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

    Energy Technology Data Exchange (ETDEWEB)

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvao Vieira; Matushita Junior, Joao Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens, E-mail: macellomaciel@me.com [A.C.Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2014-09-15

    Objective: To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods: Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results: Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paraesthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion: CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. (author)

  14. The effects of timing of fine needle aspiration biopsies on gene expression profiles in breast cancers

    International Nuclear Information System (INIS)

    Wong, Vietty; Wang, Dong-Yu; Warren, Keisha; Kulkarni, Supriya; Boerner, Scott; Done, Susan Jane; Leong, Wey Liang

    2008-01-01

    DNA microarray analysis has great potential to become an important clinical tool to individualize prognostication and treatment for breast cancer patients. However, with any emerging technology, there are many variables one must consider before bringing the technology to the bedside. There are already concerted efforts to standardize protocols and to improve reproducibility of DNA microarray. Our study examines one variable that is often overlooked, the timing of tissue acquisition, which may have a significant impact on the outcomes of DNA microarray analyses especially in studies that compare microarray data based on biospecimens taken in vivo and ex vivo. From 16 patients, we obtained paired fine needle aspiration biopsies (FNABs) of breast cancers taken before (PRE) and after (POST) their surgeries and compared the microarray data to determine the genes that were differentially expressed between the FNABs taken at the two time points. qRT-PCR was used to validate our findings. To examine effects of longer exposure to hypoxia on gene expression, we also compared the gene expression profiles of 10 breast cancers from clinical tissue bank. Using hierarchical clustering analysis, 12 genes were found to be differentially expressed between the FNABs taken before and after surgical removal. Remarkably, most of the genes were linked to FOS in an early hypoxia pathway. The gene expression of FOS also increased with longer exposure to hypoxia. Our study demonstrated that the timing of fine needle aspiration biopsies can be a confounding factor in microarray data analyses in breast cancer. We have shown that FOS-related genes, which have been implicated in early hypoxia as well as the development of breast cancers, were differentially expressed before and after surgery. Therefore, it is important that future studies take timing of tissue acquisition into account

  15. Malignant-looking thyroid nodules with size reduction: Core needle biopsy results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ha Young; Baek, Jung Hwan; Ha, Eun Jun; Park, Jee Won; Lee, Jeong Hyun; Song, Dong Eun; Shong, Young Kee [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.

  16. Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

    International Nuclear Information System (INIS)

    Koethe, Yilun; Xu, Sheng; Velusamy, Gnanasekar; Wood, Bradford J.; Venkatesan, Aradhana M.

    2014-01-01

    To compare the accuracy of a robotic interventional radiologist (IR) assistance platform with a standard freehand technique for computed-tomography (CT)-guided biopsy and simulated radiofrequency ablation (RFA). The accuracy of freehand single-pass needle insertions into abdominal phantoms was compared with insertions facilitated with the use of a robotic assistance platform (n = 20 each). Post-procedural CTs were analysed for needle placement error. Percutaneous RFA was simulated by sequentially placing five 17-gauge needle introducers into 5-cm diameter masses (n = 5) embedded within an abdominal phantom. Simulated ablations were planned based on pre-procedural CT, before multi-probe placement was executed freehand. Multi-probe placement was then performed on the same 5-cm mass using the ablation planning software and robotic assistance. Post-procedural CTs were analysed to determine the percentage of untreated residual target. Mean needle tip-to-target errors were reduced with use of the IR assistance platform (both P < 0.0001). Reduced percentage residual tumour was observed with treatment planning (P = 0.02). Improved needle accuracy and optimised probe geometry are observed during simulated CT-guided biopsy and percutaneous ablation with use of a robotic IR assistance platform. This technology may be useful for clinical CT-guided biopsy and RFA, when accuracy may have an impact on outcome. (orig.)

  17. Accuracy and efficacy of percutaneous biopsy and ablation using robotic assistance under computed tomography guidance: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Koethe, Yilun [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States); Duke University School of Medicine, Durham, NC (United States); Xu, Sheng [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); Velusamy, Gnanasekar [Perfint Healthcare Pvt. Ltd., Chennai (India); Wood, Bradford J. [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States); Venkatesan, Aradhana M. [National Institutes of Health, Center for Interventional Oncology, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States); National Institutes of Health, Center for Interventional Oncology, Radiology and Imaging Sciences, NIH Clinical Center, Bethesda, MD (United States)

    2014-03-15

    To compare the accuracy of a robotic interventional radiologist (IR) assistance platform with a standard freehand technique for computed-tomography (CT)-guided biopsy and simulated radiofrequency ablation (RFA). The accuracy of freehand single-pass needle insertions into abdominal phantoms was compared with insertions facilitated with the use of a robotic assistance platform (n = 20 each). Post-procedural CTs were analysed for needle placement error. Percutaneous RFA was simulated by sequentially placing five 17-gauge needle introducers into 5-cm diameter masses (n = 5) embedded within an abdominal phantom. Simulated ablations were planned based on pre-procedural CT, before multi-probe placement was executed freehand. Multi-probe placement was then performed on the same 5-cm mass using the ablation planning software and robotic assistance. Post-procedural CTs were analysed to determine the percentage of untreated residual target. Mean needle tip-to-target errors were reduced with use of the IR assistance platform (both P < 0.0001). Reduced percentage residual tumour was observed with treatment planning (P = 0.02). Improved needle accuracy and optimised probe geometry are observed during simulated CT-guided biopsy and percutaneous ablation with use of a robotic IR assistance platform. This technology may be useful for clinical CT-guided biopsy and RFA, when accuracy may have an impact on outcome. (orig.)

  18. Concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation.

    Science.gov (United States)

    Li, John; Weissberg, Zoe; Bevilacqua, Thomas A; Yu, Gordon; Weber, Kristy; Sebro, Ronnie

    2018-04-01

    To compare the concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation. Retrospective review of 215 FNAs of osseous lesions performed in conjunction with core biopsy at our institution over a 6-year period (2011-2016). FNAs were interpreted independently of core biopsies. We assessed if FNA in conjunction with core biopsy increased diagnostic accuracy compared to core biopsy alone. We also calculated the concordance between FNA and core biopsy by lesion appearance, lesion CT attenuation, lesion histology, lesion location and FNA needle gauge size. Core biopsy alone provided the diagnosis in 207/215 cases (96.3%), however, the FNA provided the diagnosis in the remaining 8/215 cases (3.7%) where the core biopsy was non-diagnostic. There were 154 (71.6%) lytic lesions, 21 (9.8%) blastic lesions, 25 (11.6%) mixed lytic and blastic lesions and 15 (7.0%) lesions that were neither lytic nor blastic. The concordance between FNA and core biopsy for lytic osseous lesions (136/154 cases, 88.3%) was statistically significantly higher than that for blastic osseous lesions (13/21 cases, 61.9%) [P = 4.2 × 10 -3 ; 95% CI (0.02, 0.50)]. The concordance between FNA and core biopsy was higher for low-attenuation- (110/126) than high-attenuation (58/77) lesions (P = 0.028). The concordance between FNA and core biopsy was also higher for metastases (102/119 cases, 85.7%) than non-metastases (78/96, 81.3%) [P = 0.487; 95% CI (- 0.15, 0.065)]. There was no difference in the rate of concordance between FNA and core biopsy by lesion location or FNA needle gauge size (P > 0.05). FNA with core biopsy increases diagnostic rate compared to core biopsy alone or FNA alone. The concordance between FNA and core biopsy is higher for lytic lesions than for blastic lesions; and higher for low-attenuation lesions than for high-attenuation lesions.

  19. Comparison of Histologic Core Portions Acquired from a Core Biopsy Needle and a Conventional Needle in Solid Mass Lesions: A Prospective Randomized Trial.

    Science.gov (United States)

    Lee, Ban Seok; Cho, Chang-Min; Jung, Min Kyu; Jang, Jung Sik; Bae, Han Ik

    2017-07-15

    The superiority of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) over EUS-guided fine needle aspiration (EUS-FNA) remains controversial. Given the lack of studies analyzing histologic specimens acquired from EUS-FNB or EUS-FNA, we compared the proportion of the histologic core obtained from both techniques. A total of 58 consecutive patients with solid mass lesions were enrolled and randomly assigned to the EUS-FNA or EUS-FNB groups. The opposite needle was used after the failure of core tissue acquisition using the initial needle with up to three passes. Using computerized analyses of the scanned histologic slide, the overall area and the area of the histologic core portion in specimens obtained by the two techniques were compared. No significant differences were identified between the two groups with respect to demographic and clinical characteristics. Fewer needle passes were required to obtain core specimens in the FNB group (pcore (11.8%±19.5% vs 8.0%±11.1%, p=0.376) or in the diagnostic accuracy (80.6% vs 81.5%, p=0.935) between two groups. The proportion of histologic core and the diagnostic accuracy were comparable between the FNB and FNA groups. However, fewer needle passes were required to establish an accurate diagnosis in EUS-FNB.

  20. CT guided percutaneous renal cysts puncture with ethanol therapy

    International Nuclear Information System (INIS)

    Zhang Xuezhe; Lu Yan; Wang Wu; Huang Zhengguo; Ren An

    2002-01-01

    Objective: To analyse our clinical experience with CT guided percutaneous renal cysts puncture and ethanol therapy. Methods: Five hundred and ten renal cysts in 445 patients were undergone CT guided percutaneous renal cysts puncture and ethanol therapy. Among the 445 cases, 385 cases had solitary renal cyst, 53 multiple renal cysts, and 7 polycystic kidneys. The renal cysts varied in size from 1.9 to 13.5 cm in diameter. The amount of aspirated fluid varied from 3 to 780 ml. A 18-21 gauge aspiration needles were used for all patients. A 25.0% cyst volume replacement with 99.7% ethanol was approved to be appropriate. Results: 427 renal cysts in 396 patients were followed up by computed tomographic (CT) or ultrasound for less than 3 months to more than one year duration. The curative effective rate and disappearance rate of the renal cystic cavity in solitary renal cysts were 97% and 82%, respectively. In multiple renal cysts, the corresponding values were 95% and 79%. In polycystic kidneys, the curative rate was 67%. The complications such as local abdominal pain (28 cases) and hematuria (four cases) were observed in this series. There were no fatal complications. Conclusions: CT guided percutaneous renal cyst puncture and ethanol therapy is an useful procedure for the treatment of solitary renal cysts and multiple renal cysts

  1. Ultrasound guided fine needle aspiration cytology versus core biopsy in the preoperative assessment of non-palpable breast lesions

    International Nuclear Information System (INIS)

    Ahmed, M.E.; Ahmad, I.

    2010-01-01

    Background: Breast screening is a method of detecting breast cancer at a very early stage. Most of the lesions detected by screening are not malignant. Objective of this study was to compare ultrasound guided fine needle aspiration cytology and core biopsy in the preoperative assessment of non-palpable breast lesions. Methods: The study was conducted prospectively at Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan from March 2004 to February 2005. All the patients underwent fine needle aspiration cytology and core biopsy. Later on, all of them had excision biopsy/ mastectomy. Prospectively 80 patients were studied; information was collected on a specifically designed form according to inclusion criteria. The patient age, sex, medical record number and side of lesion were recorded. Clinical history of duration of lump was also taken. Informed consent was obtained. Results: The age of patients were ranges from 20-71 years, with mean of 44.31+- 11.002 and the maximum number of patients 28 (35.3%) was between the ages 50 - 59 years. The sensitivity of FNAC was 92.85%, while the specificity of was 90% and the accuracy rate was 92.1%. The sensitivity of core biopsy was 94.64%, specificity 91.30% and accuracy rate was 94.87%. Conclusion: Fine Needle Aspiration has been found to be an extremely useful method for the diagnosis of lumps of breast. The accuracy and the sensitivity of diagnosis on fine needle aspiration cytology were high. (author)

  2. What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

    NARCIS (Netherlands)

    Barwari, K.; Kümmerlin, I.P.E.D.; Ten Kate, F.J.; Algaba, F.; Trias, I.; Wijkstra, H.; Rosette, de la J.J.M.C.H.; Laguna, M.P.

    2013-01-01

    Purpose Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by

  3. What is the added value of combined core biopsy and fine needle aspiration in the diagnostic process of renal tumours?

    NARCIS (Netherlands)

    Barwari, K.; Kummerlin, I. P.; ten Kate, F. J.; Algaba, F.; Trias, I.; Wijkstra, H.; de la Rosette, J. J.; Laguna, P.

    2013-01-01

    Non-diagnostic results still hinder the routine use of core biopsy (CB) and fine needle aspiration (FNA) in the diagnostic process of renal tumours. Furthermore, substantial interobserver variability has been reported. We assessed the added value of combining the results of CB and FNA by five

  4. Paraffin-gel tissue-mimicking material for ultrasound-guided needle biopsy phantom.

    Science.gov (United States)

    Vieira, Sílvio L; Pavan, Theo Z; Junior, Jorge E; Carneiro, Antonio A O

    2013-12-01

    Paraffin-gel waxes have been investigated as new soft tissue-mimicking materials for ultrasound-guided breast biopsy training. Breast phantoms were produced with a broad range of acoustical properties. The speed of sound for the phantoms ranged from 1425.4 ± 0.6 to 1480.3 ± 1.7 m/s at room temperature. The attenuation coefficients were easily controlled between 0.32 ± 0.27 dB/cm and 2.04 ± 0.65 dB/cm at 7.5 MHz, depending on the amount of carnauba wax added to the base material. The materials do not suffer dehydration and provide adequate needle penetration, with a Young's storage modulus varying between 14.7 ± 0.2 kPa and 34.9 ± 0.3 kPa. The phantom background material possesses long-term stability and can be employed in a supine position without changes in geometry. These results indicate that paraffin-gel waxes may be promising materials for training radiologists in ultrasound biopsy procedures. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  5. Comparison of specimen adequacy in fine-needle aspiration biopsies performed by surgeons and pathologists

    International Nuclear Information System (INIS)

    Al-Marzooq, Yusef M.; Chopra, Rajan; Al-Bahrani, Ahmed T.; Younis, Mohammad; Al-Mulhim, Abdulrahman S.; Al-Mommatten, Mohammed I.

    2004-01-01

    Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons. In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared. Of 692 FNAB's, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6% of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic. The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnstic accuracy of FNAB technique. (author)

  6. Helical-Tip Needle for Transthoracic Percutaneous Image-Guided Biopsy of Lung Tumors: Results of a Pilot Prospective Comparative Study with a Standard Tru-Cut Needle

    Energy Technology Data Exchange (ETDEWEB)

    Veltri, Andrea, E-mail: andrea.veltri@unito.it; Busso, Marco; Sardo, Diego; Angelino, Valeria; Priola, Adriano M. [University of Torino, Department of Radiology, San Luigi Gonzaga Hospital (Italy); Novello, Silvia [University of Torino, Department of Oncology, San Luigi Gonzaga Hospital (Italy); Barba, Matteo [University of Torino, Department of Radiology, San Luigi Gonzaga Hospital (Italy); Gatti, Gaia; Righi, Luisella [University of Torino, Department of Pathology, San Luigi Gonzaga Hospital (Italy)

    2017-06-15

    PurposeTo prospectively evaluate feasibility and diagnostic performance of the 14-gauge helical-tip (Spirotome™, Cook{sup ®} Medical, Bloomington, USA) needle in transthoracic needle biopsy (TTNB) of lung lesions, compared to a conventional 18-gauge Tru-Cut needle.Materials and MethodsStudy was institutional review board approved, with informed consent obtained. Data from synchronous Spirotome and Tru-Cut image-guided TTNB of 20 consecutive patients with malignant peripheral lung tumors larger than 3 cm were enrolled for pathologic characterization and mutational analysis. Samples obtained with Spirotome and Tru-Cut needle were compared for fragmentation, length, weight, morphologic and immunohistochemistry typifying, tumor cellularity (TC) and DNA concentration.ResultsThe technical success rate for TTNB with Spirotome was 100%, and no major complications occurred. Less fragmentation (mean 2 vs. 3 fragments, P = .418), greater weight (mean 13 vs. 8.5 mg, P = .027) and lower length (mean 10.2 vs. 12.6 mm, P = .174) were observed with Spirotome compared to Tru-Cut needle. Accuracy of Spirotome and Tru-Cut needle in defining cancer histotype was similar (90%). Absolute and relative TC (mean 42 vs. 38, 124 vs. 108/10HPF), and DNA concentration (mean 49.6 vs. 39.0 ng/μl) were higher with Spirotome compared to Tru-Cut needle, with no statistical significance (P = .787 and P = .140, respectively).Conclusions Percutaneous 14-gauge Spirotome TTNB of selected lesions is feasible and accurate. It provides adequate samples for diagnosis, comparable to 18-gauge Tru-Cut needle, with a higher amount of tumor tissue (weight, TC, DNA concentration) even in shorter samples.

  7. Long term clinical follow-up of atypical ductal hyperplasia and lobular carcinoma in situ in breast core needle biopsies.

    Science.gov (United States)

    Renshaw, Andrew A; Gould, Edwin W

    2016-01-01

    Atypical ductal hyperplasia (ADH) and lobular carcinoma in situ (LCIS) may be associated with a relatively high incidence of invasive carcinoma and ductal carcinoma in situ (DCIS) on immediate excision when found on core needle biopsy of the breast. However, the long term significance of ADH and LCIS in a breast core needle biopsy is not as well characterised. We reviewed the results of all breast core needle biopsies with a diagnosis of ADH or LCIS and immediate excision from the years 2000-2004, and correlated the results with long term clinical follow-up. Of 175 biopsies with ADH, 53 (30.3%) had carcinoma (8 invasive, and 45 DCIS) at the time of immediate re-excision. Of 69 biopsies with LCIS, three (4.3%) had carcinoma (2 invasive, and 1 DCIS) at the time of immediate re-excision. A total of 14 (11.5%) patients with ADH and benign re-excisions developed invasive carcinoma (12) or DCIS (2) on follow-up. A total of 17 (25.8%) patients with LCIS and benign re-excisions developed invasive carcinoma (13) or DCIS (4) on follow-up. The risk of invasive carcinoma or DCIS on immediate re-excision was significantly higher for women with ADH than LCIS (pfibrocystic changes (FCC) on core needle biopsy, the risk of developing invasive carcinoma or DCIS was significantly higher for women with ADH and benign initial re-excisions (95% CI 1.092-7.297, p=0.03), and women with LCIS and benign re-excisions (95% CI 3.028-18.657, p<0.001). Overall, 67/175 (38.3%) women with ADH and 20/69 (29.0%) women with LCIS on core needle biopsy either had carcinoma at the time of the biopsy or later developed carcinoma. Significantly more women with LCIS developed invasive carcinoma or DCIS than women with ADH on long term follow-up. The relative risk for ADH and LCIS on core biopsy with a negative excision compared with FCC was similar to that reported in the literature (ADH 1-7×, LCIS 3-19×). Copyright © 2015 The Royal College of Pathologists of Australasia. Published by Elsevier B.V. All

  8. Distinguishing papillary endothelial hyperplasia and angiosarcoma on core needle biopsy of the breast: The importance of clinical and radiologic correlation.

    Science.gov (United States)

    Guilbert, Marie-Christine; Frost, Elisabeth P; Brock, Jane E; Lester, Susan C

    2018-02-24

    Papillary endothelial hyperplasia (PEH) is a rare non-neoplastic exuberant organizing hematoma that can closely mimic angiosarcoma due to a resemblance to malignant anastomosing blood vessels. It could be particularly difficult to distinguish PEH from angiosarcoma in breast core needle biopsies. We identified all cases of these lesions diagnosed on core needle biopsy in order to identify clinical, radiologic, and pathologic features that could prove helpful to arrive at the correct diagnosis. Four cases of PEH and 4 cases of angiosarcoma were identified. The mean age at diagnosis was 62 for PEH and 33 for primary angiosarcoma. All cases of PEH formed small masses with circumscribed or lobulated margins by imaging (mean size 0.9 cm). In 3 cases, the masses were difficult or impossible to identify after the biopsy. Angiosarcomas presented as larger masses with ill-defined margins (mean size 2.8 cm) that were unchanged in size after biopsy. PEH was surrounded by adipose tissue, whereas angiosarcoma invaded into fibrous stroma and involved lobules. The pseudopapillary structures of PEH were composed mainly of collagen, and thus, additional histologic stains for fibrin were not helpful for diagnosis. The 4 patients with PEH received no further treatment and are alive and disease-free at 2-11 years of follow-up. In contrast, the patients with angiosarcoma underwent mastectomy and chemotherapy or radiation therapy. Two of the patients with angiosarcoma died 3 years after diagnosis and the other 2 patients are alive without disease at 5 and 6 years. Therefore, distinguishing PEH and angiosarcoma is essential for appropriate management. This is the first series to compare these lesions on core needle biopsy and the first to note important clinical, imaging, and histologic differences that aid in making a diagnosis of PEH with confidence on breast core needle biopsy. © 2018 Wiley Periodicals, Inc.

  9. Ultrasound-guided fine-needle aspiration biopsy of the thyroid.

    Science.gov (United States)

    Tambouret, R; Szyfelbein, W M; Pitman, M B

    1999-10-25

    We reviewed the Massachusetts General Hospital experience with ultrasound-guided fine-needle aspiration biopsies (FNABs) of the thyroid to determine the indications, rate of unsatisfactory smears, correlation with excisional biopsy results, and verification of efficient use of personnel time. All radiologically guided FNABs of the thyroid from January 1993 through June 1997 were reviewed. As a measure of efficient use of technologist time, a sample of times spent by the technologist during the procedure for 20 cases in 1993 and 1997 was compared with that of an equal number of random nonthyroid image guided FNABs. Two hundred-ninety FNABs were identified in 251 patients, representing 12% of all thyroid FNABs and 11% of all radiologically guided FNABs. Indications in the 251 patients included multiple nodules (78), solitary nodules (61), complex nodules (39), prior failed FNAB (39), thyroid bed abnormalities post-thyroidectomy (21), difficult access (7), and investigation of recurrent tumor in residual thyroid lobe (6). Available records indicated 118 lesions were palpable and 45 were nonpalpable; the physical examination characteristics of the remainder (88) were not stated. Diagnoses included 44 unsatisfactory cases (15%), 103 macrofollicular lesions, 20 microfollicular lesions, 26 mixed macro/microfollicular lesions, 5 oxyphilic lesions, 1 trabecular pattern, 15 nonspecific follicular cell pattern, 9 follicular cell atypia, 30 cysts, 11 thyroiditis, 23 malignant tumors, and 3 other (1 parathyroid, 2 lymph node). Eighty-nine FNABs from 76 patients had subsequent surgical biopsy. Excisional biopsies in 14 unsatisfactory FNABs were benign. In the remaining 75 FNABs from 67 patients, 18 malignancies on FNAB were correctly diagnosed, but 3 other papillary carcinomas were only qualified as atypical follicular cells on cytology. No false-positive cases occurred. Of 15 macrofollicular lesions on cytology, 10 were adenomas on excision, only 2 of which were microfollicular

  10. Ultrathin needle (25G) aspiration lung biopsy: diagnostic accuracy and complication rates

    International Nuclear Information System (INIS)

    Oikonomou, A.; Matzinger, F.R.; Seely, J.M.; Dennie, C.J.; Macleod, P.J.

    2004-01-01

    The aim of this study was to evaluate the diagnostic accuracy and complication rate of 25-G fine-needle aspiration biopsy (FNAB) of the lung in patients with suspected malignant focal lesions and abnormal lung function. The 25-G FNAB was performed in 123 patients who underwent prebiopsy CT and pulmonary function tests. Retrospective evaluation included pulmonary function, cytology, size of the lesion, depth of location, presence of emphysema on CT, needle passes, pneumothorax and drainage. The final diagnosis (gold standard) was based on histopathology after surgical resection or follow-up and response to treatment. Sixty-one patients had normal lung function or mild impairment (group 1) and 62 had moderate or severe impairment (group 2). Pneumothorax occurred in 26 of 126 procedures (20.6%) with drainage needed in 11 (8.7%). In group 2 pneumothorax occurred in 19 of 63 procedures (30.15%) with drainage needed in 11 (17.5%). The sensitivity, specificity and diagnostic accuracy of cytology results were 93.6, 100 and 94.4%, respectively. FEV1 (p=0.014), FEV1/FVC (p=0.005), FEF25-75 (p=0.001), DLCO (p=0.013) and presence of emphysema on CT (p<0.001) correlated with pneumothorax (Students t test). The 25-G lung FNAB is accurate and safe in diagnosing malignancy in patients with severe lung functional abnormality. Patients with moderate to severe airway obstruction have a higher prevalence of pneumothorax than patients with mild or no functional impairment

  11. CT-guided conformal cryoablation for peripheral NSCLC: Initial experience

    International Nuclear Information System (INIS)

    Zhang, Xiao; Tian, Jinlin; Zhao, Lei; Wu, Bin; Kacher, Daniel S.; Ma, Xuyang; Liu, Shurong; Ren, Chao; Xiao, Yue-Yong

    2012-01-01

    Purpose: To study the feasibility of CT-guided and monitored percutaneous conformal cryoablation of Non-Small Cell Lung Cancer for patients who are not suitable for surgical resection. Materials and method: CT-guided percutaneous conformal cryoablation was performed on 46 patients with peripheral Non-Small Cell Lung Cancer. Patients with tumor sizes less than 3 cm in diameter were treated with double-needle clamping cryoablation, while the patients with 3–5 cm tumor sizes were treated with multiple-needle conformal cryoablation. CT was used to monitor the extent of cryoablation during the procedures. At month 1, 3, 6, 12, and 24 post-procedure, enhanced CT scans and/or PET-CT scans were performed to evaluate the impact of the therapy. Results: The average tumor CT values were 32 ± 10 HU and −21 ± 8 HU before and after cryoablation, respectively. The largest diameters of the lesions at month 1, 3, 6, 12, and 24 post-procedure were 2.63 ± 0.56 cm, 1.93 ± 0.51 cm, 1.55 ± 0.39 cm, 1.43 ± 0.40 cm, and 1.38 ± 0.38 cm, respectively, in patients with tumor diameter less than 3 cm, and 3.63 ± 0.39 cm, 2.98 ± 0.31 cm, 2.62 ± 0.32 cm, 2.54 ± 0.34 cm, and 2.56 ± 0.37 cm respectively in patients with the tumor diameters between 3 and 5 cm. At the 24th month, there were 36 cases of complete response (83.7%), 7 cases of partial response (16.3%), and no cases of stable disease or progressive disease. 3 patients died due to multiple metastases. Conclusion: CT-guided percutaneous conformal cryoablation is a safe, effective, and minimally invasive therapeutic method for peripheral lung cancer.

  12. PET/CT-guided Interventions: Personnel Radiation Dose

    International Nuclear Information System (INIS)

    Ryan, E. Ronan; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P.; Hsu, Meier; Quinn, Brian; Dauer, Lawrence T.; Solomon, Stephen B.

    2013-01-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0–0.13) mSv for the primary operator, 0.01 (range 0–0.05) mSv for the nurse anesthetist, and 0.02 (range 0–0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0–0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient

  13. PET/CT-guided Interventions: Personnel Radiation Dose

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States); Quinn, Brian; Dauer, Lawrence T. [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)

    2013-08-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

  14. En bloc excision of nonpalpable breast lesions using the advanced breast biopsy instrumentation system: an alternative to needle guided surgery?

    International Nuclear Information System (INIS)

    Lifrange, E.; Colin, C.; Dondelinger, R.F.; Fridman, V.

    2001-01-01

    This study was prospectively conducted to evaluate the clinical potential of the advanced breast biopsy instrumentation (ABBI) system as an alternative to needle localization and open surgery in the management of nonpalpable breast lesions (NPBL). One hundred and eighty-six consecutive patients were referred for management of NPBL. Thirty-six underwent an ABBI procedure, offered as a first step before possible surgery for lesions which would in any case have required complete excision. The 18 patients with a malignant ABBI biopsy underwent re-excision of the biopsy site and axillary dissection was carried out in cases of infiltrating carcinoma. The other 150 patients underwent image-guided needle biopsy. Following these procedures, 60/150 (40 %) patients underwent needle-guided surgery. Finally, 96/186 (51 %) patients required complete excision. A total of 43 benign lesions and 53 carcinomas were confirmed. Thirty-six out of 96 (38 %) excisions were obtained with the ABBI system; 17/43 (40 %) benign lesions and 11/53 (21 %) carcinomas were completely removed with the ABBI system. Out of 9 malignant specimens with a pathological size less than 10 mm, 5/9 (55 %) had tumor-free margins and in 8/9 (89 %) no residual disease was found at re-excision. The preliminary results of this study suggest that, in selected cases, en bloc excision using the ABBI procedure could be an alternative to conventional surgery. (orig.)

  15. Guide for the realization of core needle biopsy through stereotaxy in the diagnosis of suspicious breast lesions of malignity

    International Nuclear Information System (INIS)

    Jimenez Zuniga, Jorge Luis

    2012-01-01

    Guides have been made for the realization of breast biopsies through stereotaxy in the management of breast lesions. The type of injuries that have been detected in mammography services, most have corresponded to nonpalpable lesions, that should be clarified through the take samples for an histological study with the purpose of categorize them. A bibliographic review was realized of the findings most frequent in the breast pathology. Also, before a nonpalpable breast lesion that requires a diagnosis biopsy, should be assessed the method of suitable guide for to access the same. The interventionist procedures of the breast have been developed in last years and have been guided by stereotaxy, in order to preoperative localization of these lesions or for obtaining valid cytologic-histologic material to reach a diagnosis, as it has often been difficult to differentiate, just for the image, between benign and malignant lesions. Thus, has emerged the necessity to guide the needle tip objectifying the lesion through mammography. A localization system based on triangulation is applied. The location of the lesion is calculated in the three axes of space (X, Y and Z) with a minimum error. The stereotactic devices have created to guide needles to injuries from a unique projection. This has allowed that breast and lesion are subject on a site while have taken samples several times. The complete mammography study that include the projections craniocaudal (CC) and mediolateral oblique (MLO) are analyzed to find out exactly on which quadrant has found the injury. Sometimes, the injury only has observed in a unique projection which is used for locating. The two main devices that have been used to perform stereotactic biopsy are automatic gun of biopsy and vacuum-assisted directional biopsy. Automatic gun of biopsy has used a long needle tru-cut type, with calibers between 18 and 14, although it is preferred 14-gauge needles. Multiple samples obtained from this needle have

  16. Core needle biopsy of the thyroid: 2016 consensus statement and recommendations from Korea society of thyroid radiology

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dong Gyu [Dept. of Radiology, Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Baek, Jung Hwan; Lee, Jeong Hyun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); and others

    2017-01-15

    Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus.

  17. Diagnostic Accuracy of MRI-guided Percutaneous Transthoracic Needle Biopsy of Solitary Pulmonary Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Shangang, E-mail: 1198685580@qq.com [University of Jinan-Shandong Academy of Medical Science, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences (China); Li, Chengli, E-mail: chenglilichina@yeah.net [Shandong University, Department of Interventional MRI, Shandong Medical Imaging Research Institute (China); Yu, Xuejuan, E-mail: yuxuejuan2011@126.com [University of Jinan-Shandong Academy of Medical Science, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences (China); Liu, Ming, E-mail: mingliuyxs@163.com [Shandong University, Department of Interventional MRI, Shandong Medical Imaging Research Institute (China); Fan, Tingyong, E-mail: FTY681105@sohu.com; Chen, Dong, E-mail: 857984870@qq.com; Zhang, Pinliang, E-mail: zhangpinliang@163.com; Ren, Ruimei, E-mail: liusg708@qq.com [University of Jinan-Shandong Academy of Medical Science, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences (China)

    2015-04-15

    ObjectiveThe purpose of our study was to evaluate the diagnostic accuracy of MRI-guided percutaneous transthoracic needle biopsy (PTNB) of solitary pulmonary nodules (SPNs).MethodsRetrospective review of 69 patients who underwent MR-guided PTNB of SPNs was performed. Each case was reviewed for complications. The final diagnosis was established by surgical pathology of the nodule or clinical and imaging follow-up. Pneumothorax rate and diagnostic accuracy were compared between two groups according to nodule diameter (≤2 vs. >2 cm) using χ{sup 2} chest and Fisher’s exact test, respectively.ResultsThe success rate of single puncture was 95.6 %. Twelve (17.4 %) patients had pneumothorax, with 1 (1.4 %) requiring chest tube insertion. Mild hemoptysis occurred in 7 (7.2 %) patients. All of the sample material was sufficient for histological diagnostic evaluation. Pathological analysis of biopsy specimens showed 46 malignant, 22 benign, and 1 nondiagnostic nodule. The final diagnoses were 49 malignant nodules and 20 benign nodules basing on postoperative histopathology and clinical follow-up data. One nondiagnostic sample was excluded from calculating diagnostic performance. A sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in diagnosing SPNs were 95.8, 100, 97.0, 100, and 90.9 %, respectively. Pneumothorax rate, diagnostic sensitivity, and accuracy were not significantly different between the two groups (P > 0.05).ConclusionsMRI-guided PTNB is safe, feasible, and high accurate diagnostic technique for pathologic diagnosis of pulmonary nodules.

  18. Preoperative core needle biopsy is accurate in determining molecular subtypes in invasive breast cancer

    International Nuclear Information System (INIS)

    Chen, Xiaosong; Yuan, Ying; Fei, Xiaochun; Jin, Xiaolong; Shen, Kunwei; Sun, Long; Mao, Yan; Zhu, Siji; Wu, Jiayi; Huang, Ou; Li, Yafen; Chen, Weiguo; Wang, Jianhua

    2013-01-01

    Estrogen receptor (ER), progesterone receptor (PgR), HER2, and Ki67 have been increasingly evaluated by core needle biopsy (CNB) and are recommended for classifying breast cancer into molecular subtypes. However, the concordance rate between CNB and open excision biopsy (OEB) has not been well documented. Patients with paired CNB and OEB samples from Oct. 2009 to Feb. 2012 in Ruijin Hospital were included. ER, PgR, HER2, and Ki67 were determined by immunohistochemistry (IHC). Patients with HER2 IHC 2+ were further examined by FISH. Cutoff value for Ki67 high expression was 14%. Molecular subtypes were constructed as follows: Luminal A, Luminal B, Triple Negative, and HER2 positive. There were 298 invasive breast cancer patients analyzed. Concordance rates for ER, PgR, and HER2 were 93.6%, 85.9%, and 96.3%, respectively. Ki67 expression was slightly higher in OEB than in CNB samples (29.3% vs. 26.8%, P = 0.046). Good agreement (κ = 0.658) was demonstrated in evaluating molecular subtypes between CNB and OEB, with a concordance rate of 77.2%. We also used a different Ki67 cutoff value (20%) for determining Luminal A and B subtypes in HR (hormone receptor) +/HER2- diseases and the overall concordance rate was 79.2%. However, using a cut-point of Ki67 either 14% or 20% for both specimens, there will be about 14% of HR+/HER2- specimens that are called Luminal A on CNB and Luminal B on OEB. CNB was accurate in determining ER, PgR, and HER2 status as well as non-Luminal molecular subtypes in invasive breast cancer. Ki67 should be retested on OEB samples in HR+/HER2- patients to accurately distinguish Luminal A from B tumors

  19. Evaluation of a mammographic stereotactic device for localization, fine-needle aspiration cytologic studies, and core biopsy of suspicious lesions

    International Nuclear Information System (INIS)

    Fajardo, L.J.; Davey, G.A.

    1988-01-01

    Mammography-guided interventional breast procedures, such as preoperative localization, fine-needle aspiration cytology (FNAC), and core biopsy of suspicious lesions, require accurate three-dimensional localization. The authors have evaluated a prototype stereotactic mammography device for localizing abnormalities with both phantom and clinical studies. Twenty-six localizations on a phantom were within 0.5 mm +- 0.93 (standard deviation) from the lesions; accuracy in clinical procedures was within 0.6 mm +- 0.8. Procedures are performed an average of 8 minutes faster with this device. They are prospectively evaluating mammography-guided FNAC and core biopsy of suspicious lesions in 100 patients. Results of FNAC performed without the stereotactic device agreed with results of open surgical biopsy in six of eight patients; results of core biopsy agreed in seven of eight

  20. Endoscopic ultrasound with fine needle aspiration and biopsy in lung cancer and isolated mediastinal lymphadenopathy.

    LENUS (Irish Health Repository)

    Nadarajan, P

    2010-03-01

    Endoscopic ultrasound with fine-needle aspiration and biopsy (EUS-FNAB) is well established in diagnosing and staging lung cancer in patients with mediastinal adenopathy. EUS-FNAB is highly sensitive, less invasive and has lower complication rates when compared to surgical staging of mediastinal nodes. In this study we describe our experience of EUS-FNAB in lung cancer and other causes of mediastinal lymphadenopathy. EUS-FNAB was performed for assessment of PET positive mediastinal lymph nodes between January 2007 and March 2009 in AMNCH. The endpoints of our study were sensitivity and specificity of EUS-FNAB, morbidity and length of hospital stay. Thirty four patients underwent EUS-FNAB during the study period for both diagnosis and staging. Thirty patients had positive lymph node invasion and 4 had no evidence of malignant invasion. In these 4 patients negative cytology was confirmed on mediastinoscopy giving EUS-FNAB a sensitivity and specificity of 100%. EUS-FNAB upstaged the disease in 12 patients. EUS-FNAB is a reliable tool for mediastinal staging in lung cancer, significantly reducing the need for surgical staging procedures in patients with suspected mediastinal involvement.

  1. Accuracy of frozen-section combined with imprint and fine needle aspiration biopsy in thyroid nodules

    Directory of Open Access Journals (Sweden)

    Benyamin Makes

    2007-06-01

    Full Text Available Thyroid malignancy can be found on 5% of thyroid nodules. In order to better managed of thyroid nodules, skills to differentiate benign from malignant cases were needed. Fine needle aspiration biopsy (FNAB was done preoperatively while frozen section (FS and imprint cytology (IC should be done intra-operatively. The objective of this research paper is to evaluate the diagnostic accuracy of FNAB versus frozen section combined with imprint cytology (FS+IC in thyroid nodules at the Anatomic-Pathology Department FMUI-CM Hospital, Jakarta. This diagnostic test, used data from clinico-pathological records in Anatomic Pathology Department, Faculty of Medicine University of Indonesia / Dr.Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during 1999-2003. Specimens with complete data of FNAB results, data of FS and slides of IC. All formalin fixed`specimens were reevaluated and used as the golden standard. Sensitivity, spesificity and accuracy of FS+IC were higher than FNAB (86.8% vs 73.7% ; 99.0% vs 83.9% ; 94.8% vs 80.5% respectively. If the results of FNAB were concordant with the result of FS+IC, the combined examination yields accuracy of 95.1%. The evaluation of frozen section combined with imprint cytology is very useful, because this examination significantly showed high accuracy in diagnosing thyroid malignancy. (Med J Indones 2007; 16:89-93Keywords: thyroid nodules, FNAB, frozen section, imprint cytology, accuracy

  2. Significant histologic features differentiating cellular fibroadenoma from phyllodes tumor on core needle biopsy specimens.

    Science.gov (United States)

    Yasir, Saba; Gamez, Roberto; Jenkins, Sarah; Visscher, Daniel W; Nassar, Aziza

    2014-09-01

    Cellular fibroepithelial lesions (CFELs) are a heterogeneous group of tumors encompassing cellular fibroadenoma (CFA) and phyllodes tumor (PT). Distinction between the two is challenging on core needle biopsy (CNB) specimens. The objective of this study was to evaluate histologic features that can help distinguish PT from CFA on CNB specimens. Records of all patients diagnosed with CFELs on CNB specimens with follow-up excision between January 2002 and December 2012 were retrieved. Histopathologic stromal features were evaluated on CNB specimens, including mitoses per 10 high-power fields (hpf), overgrowth, increased cellularity, fragmentation, adipose tissue infiltration, heterogeneity, subepithelial condensation, and nuclear pleomorphism. Twenty-seven (42.2%) of 64 were diagnosed as PT (24 benign PTs and three borderline PTs) and 37 (57.8%) as CFA on excision. All features except for increased stromal cellularity were statistically significant. The average number of histologic features seen in PT and CFA was 3.9 and 1.4, respectively (odds ratio [OR], 7.27; 95% confidence interval [CI], 2.44-21.69; P = .0004). The average number of mitoses per 10 hpf was 3.0 for PT compared with 0.8 for CFA (OR, 2.14; 95% CI, 1.18-3.86; P = .01). The presence of mitoses (three or more) and/or total histologic features of three or more on CNB specimens were the most helpful features in predicting PT on excision. Copyright© by the American Society for Clinical Pathology.

  3. Significant Histological Features Differentiating Cellular Fibroadenoma from Phyllodes Tumor on Core Needle Biopsies

    Science.gov (United States)

    Yasir, Saba; Gamez, Roberto; Jenkins, Sarah; Visscher, Daniel W.; Nassar, Aziza

    2015-01-01

    Objectives Cellular fibroepithelial lesions (CFEL) are a heterogeneous group of tumors encompassing cellular fibroadenoma (CFA) and phyllodes tumor (PT). Distinction between the two is challenging on core needle biopsy (CNB). The objective of this study was to evaluate histological features that can help distinguish PT from CFA on CNB. Methods Records of all patients diagnosed with CFEL on CNB with follow-up excision between 2002 and 2012 were retrieved. Histopathological stromal features were evaluated on CNB including mitoses per 10 HPF, overgrowth, increased cellularity, fragmentation, adipose tissue infiltration, heterogeneity, subepithelial condensation, and nuclear pleomorphism. Results Twenty-seven of 64 (42.2%) were diagnosed as PT (24 BPT, 3 borderline PT) and 37 (57.8%) as CFA on excision. All features except for increased stromal cellularity were statistically significant. The average number of histologic features seen in PT and CFA was 3.9 and 1.4, respectively (OR 7.27; 95% CI: 2.44, 21.69; p= 0.0004). The average mitoses per 10 HPF was 3.0 for PT as compared to 0.8 for CFA (OR 2.14; 95% CI: 1.18, 3.86; p= 0.01). Conclusions The presence of mitosis (3 or more) and/or total histologic features of 3 or more on CNB were most helpful features in predicting PT on excision. PMID:25125627

  4. Determination of hepatocellular carcinoma grade by needle biopsy is unreliable for liver transplant candidate selection.

    Science.gov (United States)

    Court, Colin M; Harlander-Locke, Michael P; Markovic, Daniela; French, Samuel W; Naini, Bita V; Lu, David S; Raman, Steven S; Kaldas, Fady M; Zarrinpar, Ali; Farmer, Douglas G; Finn, Richard S; Sadeghi, Saeed; Tomlinson, James S; Busuttil, Ronald W; Agopian, Vatche G

    2017-09-01

    The objective of this article is to evaluate the utility of preoperative needle biopsy (PNB) grading of hepatocellular carcinoma (HCC) as a biomarker for liver transplantation (LT) candidate selection. Given the prognostic significance of HCC tumor grade, PNB grading has been proposed as a biomarker for LT candidate selection. Clinicopathologic characteristics of HCC LT recipients (1989-2014) with a PNB were analyzed, and the concordance of PNB grade to explant grade and vascular invasion was assessed to determine whether incorporation of PNB grade to accepted transplant criteria improved candidate selection. Of 965 patients undergoing LT for HCC, 234 (24%) underwent PNB at a median of 280 days prior to transplant. Grade by PNB had poor concordance to final explant pathology (κ = 0.22; P = 0.003), and low sensitivity (29%) and positive predictive value (35%) in identifying poorly differentiated tumors. Vascular invasion was predicted by explant pathologic grade (r s = 0.24; P Liver Transplantation 23 1123-1132 2017 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

  5. Three-dimensional cytomorphology in fine needle aspiration biopsy of medullary thyroid carcinoma.

    Science.gov (United States)

    Chang, T C; Lai, S M; Wen, C Y; Hsiao, Y L; Huang, S H

    2001-01-01

    To elucidate three-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of medullary thyroid carcinoma (MTC). ENAB was performed on tumors from five patients with MTC. The aspirate was stained and observed under a light microscope (LM). The aspirate was also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). For transmission electron microscopy (TEM), the specimen was fixed, dehydrated, embedded in an Epon mixture, cut with an ultramicrotome, mounted on copper grids, electron doubly stained with uranium acetate and lead citrate, and observed with TEM. Findings under SEM were correlated with those under LM and TEM. Under SEM, 3-D cytomorphology of MTC displayed a disorganized cellular arrangement with indistinct cell borders in three cases. The cell surface was uneven and had granular protrusions that corresponded to secretory granules observed under TEM. In one case with multiple endocrine neoplasia type IIB, there were abundant granules on the cell surface. In one case of sporadic MTC with multinucleated tumor giant cells and small cells, granular protrusions also were noted on the cell surface. Granular protrusion was a characteristic finding in FNAB of MTC tinder SEM and might be helpful in the differential diagnosis.

  6. Core-needle biopsy of breast cancer is associated with a higher rate of distant metastases 5 to 15 years after diagnosis than FNA biopsy.

    Science.gov (United States)

    Sennerstam, Roland B; Franzén, Bo S H; Wiksell, Hans O T; Auer, Gert U

    2017-10-01

    The literature offers discordant results regarding whether diagnostic biopsy is associated with the dissemination of cancer cells, resulting in local and/or distant metastasis. The long-term outcomes of patients with breast cancer were compared between those who were diagnosed using either fine-needle aspiration biopsy (FNAB) or core-needle biopsy (CNB) during 2 decades: the 1970s and 1990s. In the 1970s, the only diagnostic needle biopsy method used for breast cancer in Sweden was FNAB. CNB was introduced 1989 and became established in Stockholm Gotland County in the early 1990s. The authors compared the clinical outcomes of patients diagnosed using FNAB from 1971 to 1976 (n = 354) versus those of patients diagnosed using CNB from 1991 to 1995 (n = 1729). Adjusting for differences in various treatment modalities, mammography screening, tumor size, DNA ploidy, and patient age between the 2 decades, 2 strictly matched samples representing FNAB (n = 181) and CNB (n = 203) were selected for a 15-year follow-up study. In a comparison of the rates of distant metastasis in the strictly matched patient groups from the FNAB and CNB cohorts, significantly higher rates of late-appearing (5-15 years after diagnosis) distant metastasis were observed among the patients who were diagnosed on CNB compared with those who were diagnosed on FNAB. No significant difference in local metastasis was observed between the 2 groups. At 5 to 15 years after diagnosis of the primary tumor, CNB-diagnosed patients had significantly higher rates of distant metastases than FNAB-diagnosed patients. Cancer Cytopathol 2017;125:748-56. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. [Non-palpable breast cancer malignant on needle core biopsy and no malignancy in surgical excision: how to manage?].

    Science.gov (United States)

    Cheurfa, N; Giard, S

    2015-01-01

    Despite the standard management of non-palpable breast cancer (needle core biopsy diagnostic, accurate preoperative localization), there are differences in some cases between the malignant histo-pathological finding in diagnostic biopsy results and negative histo-pathological finding after surgical excision. The aim of this study is to evaluate this incidence and classifying them under three category: failure of surgical excision after preoperative identification; removal of the tumor was already completed by percutaneous biopsy; percutaneous biopsy true false positive. We conducted a study based on prospective database, all patients included in this study had partial mastectomy for ductal carcinoma in-situ or invasive cancer which was diagnosed by needle core biopsy and normal/benign after surgery. Regarding the partial mastectomy, 1863 was performed in the last three years in our center. Thirty-seven patients (2%) correspond our study criteria. After discussion of cases in our multidisciplinary reunion, 6 patients (16%) were considered as failure of surgical excision, 26 patients (70%) as true removal of the whole lesion in the core, and 5 patients (13%) as true false-positive cores. This is the first study witch investigate all factors that influence the results of negative final histo-pathological finding of surgical excision of the tumor after malignant diagnostic needle core biopsy. This rare situation need a multidisciplinary meeting to analyse all the steps of management and to determine causes of those false results and try to find adequate management to solve this problem. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. CT guided celiac plexus and splanchnic nerve neurolysis : the modified anterior approach

    International Nuclear Information System (INIS)

    Lee, Jeong Min; Lee, Mi Suk; Ym, Seong Hee; Lee, Jin Hee

    1997-01-01

    Since it was first described by Kappis, celiac plexus neurolysis (CPN) has been performed under fluoroscopic guidance by anesthetists or surgeons for the relief of intractable pain caused by upper abdominal malignancy. Recently, however, several groups have reported a computed tomography (CT)-guided technique that increased the safety of the blocking procedure and improved its results. The authors present a new technique CT-guided celiac plexus and splanchic nerve block, to be used simultaneously with a modified anterior approach. Using CT to guide needle tip placement, an anterior approach that permitted direct neurolysis of the celiac ganglia and splanchnic nerve was developed

  9. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

    Directory of Open Access Journals (Sweden)

    Smriti Hari

    2016-01-01

    Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates.

  10. Tibialis anterior muscle needle biopsy and sensitive biomolecular methods: a useful tool in myotonic dystrophy type 1

    Directory of Open Access Journals (Sweden)

    S. Iachettini

    2015-10-01

    Full Text Available Myotonic dystrophy type 1 (DM1 is a neuromuscular disorder caused by a CTG repeat expansion in 3’UTR of DMPK gene. This mutation causes accumulation of toxic RNA in nuclear foci leading to splicing misregulation of specific genes. In view of future clinical trials with antisense oligonucleotides in DM1 patients, it is important to set up sensitive and minimally-invasive tools to monitor the efficacy of treatments on skeletal muscle. A tibialis anterior (TA muscle sample of about 60 mg was obtained from 5 DM1 patients and 5 healthy subjects through a needle biopsy. A fragment of about 40 mg was used for histological examination and a fragment of about 20 mg was used for biomolecular analysis. The TA fragments obtained with the minimally-invasive needle biopsy technique is enough to perform all the histopathological and biomolecular evaluations useful to monitor a clinical trial on DM1 patients.

  11. Adenomyoepithelioma of the breast with hemorrhagic change diagnosed as papiloma on core needle biopsy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Sun; Kim, Ji Young; Kim, Soung Hee; Bae, Kyung Eun; Lee, Ji Hae; Kang, Mi Jin; Jeong, Myeong Ja; Kim, Soo Hyun; Kim, Jae Hyung [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2016-11-15

    Adenomyoepithelioma (AME) is a rare disease entity that represents biphasic proliferation of ductal epithelial and myoepithelial cells. AME can be confused with other neoplasms including malignancy because AME has various cytologic characteristics and nonspecific radiologic features. We describe an unusual AME with hemorrhagic change that was diagnosed as papilloma on core needle biopsy three times previously. The imaging features of AME are also discussed here.

  12. Comparison of needle aspiration and vacuum-assisted biopsy in the ultrasound-guided drainage of lactational breast abscesses

    OpenAIRE

    Kang, Yun-Dan; Kim, You Me

    2015-01-01

    Purpose: The purpose of this study was to compare needle aspiration and vacuum-assistedbiopsy in the ultrasound-guided treatment of lactational breast abscesses. Methods: Between January 2005 and December 2014, a total of 74 patients presented withlactational breast abscesses. Thirty of these patients underwent treatment with antibioticsalone, while the remaining 44 lactating women with breast abscesses were treated withneedle aspiration (n=25) or vacuum-assisted biopsy (n=19). Age, duration ...

  13. Diagnosis of multiple myeloma on based the material obtained by fine needle aspiration biopsy of the lungs

    Directory of Open Access Journals (Sweden)

    Bokun Radojka

    2004-01-01

    Full Text Available The patient presented in this paper was admitted to the hospital for the evaluation of radiologically revealed shadow in both lungs. In the course of diagnostic procedures, fine needle aspiration biopsy of the intrathoracic mass was performed. Cytologic analysis of the smear was performed because of clinical suspicion of plasma cell proliferative disease that was confirmed by bone marrow aspiration. Thus, the cytologic finding of intrathoracic lesion preceded the diagnosis of multiple myeloma.

  14. A study on CT-guided stereotactic technique for functional neurosurgery

    International Nuclear Information System (INIS)

    Uetsuhara, Koichi; Asakura, Tetsuhiko; Hirahara, Kazuho; Gondo, Masazumi; Oda, Hiroshige

    1987-01-01

    Recently, CT-guided stereotactic surgery has become of major interest, and some authors have discussed its potential in functional neurosurgery. The following is a comparative study of the CT-guided stereotactic technique and the conventional roentogenographic stereotactic technique. The Brown-Roberts-Wells apparatus was used for both types of procedures. 37 stereotactic procedures were performed on 35 patients under local anesthesia; 16 for stereotactic biopsy and 21 for stereotactic functional neurosurgery. Target points for stereotactic biopsy were determined by the CT-guided technique and target points for functional neurosurgery were determined by the conventional roentogenographic technique. The correlation with the position of target point determined by both techniques was investigated in the 21 functional neurosurgical procedures. On these occasions the authors used the reformatted horizontal and sagittal CT through the anterior and posterior commissure to determine the position of target point by the CT-guided technique. Results: It was found that the AC-PC line crossed with Reid's base line at angle of 11 ± 1 deg, and therefore it is important to obtain a CT images including AC-PC line at this angle. When applying the CT guided stereotactic procedure for functional surgery, it should be known that there could be a discrepancy within 2 mm from the conventional target determination. (author)

  15. [Ecology and fluoroquinolon resistance profiles in febrile urinary tract infections (FUTI) after prostate needle biopsy: A retrospective study in 466 biopsies].

    Science.gov (United States)

    Duboureau, H; Achkar, K; Stephan, R; Schmit, J L; Saint, F

    2017-05-01

    The biopsies of prostate are the reference examination to assert the diagnosis of prostate cancer. Even if the urinary infectious complications are rare thanks to the systematic oral antibiotic prophylaxis, they may still be serious. The SPILF (Society of Infectious Pathology and French language) published in 2014, an important increase of the resistances in fluoroquinolones for Escherichia coli (3 to 25%), whereas this is the most bacterium frequently found in the urinary infections (70-80%). The objectives of this study were to estimate the indicence of the febrile urinary tract infections after prostate needle biopsy and to define the ecology and the profile of E. coli's resistance. A total of 466 transrectal ultrasound-guided needle prostate biopsy were included in the study from 2012 to 2015. All the patients were taken care according to the recommendations of the AFU (Ouzzane et al., 2011). We estimated, for all the inclusive patients, if they had presented a clinic sign of urinary infection like fever or burning which suggestive of an urinary infection, and having a urines and blood culture, in the next 30 days the realization of the medical exam. Among 466 realized biopsies, seven patients developed a febril urinary tract infection (1.5%) [prostatitis (n=6), orchitis (n=1)]. Five infections to E. coli were identified; two were resistant for fluoroquinolones (40%). No germ was able to be identified for two patients. The infectious complications post-biopsy of prostate are rare (1.5%). E. coli is the germ most frequently identified with 40% of resistance with fluoroquinolones. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Percutaneous CT-guided interventional procedures in musculoskeletal system (our experience)

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, Loukas E-mail: loutharad@yahoo.com; Mylona, Sophia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos

    2004-06-01

    Percutaneous interventional procedures include a broad spectrum of minimal invasive techniques, which are a useful diagnostic and therapeutic tool. In this study we present our experience in CT-guided percutaneous musculoskeletal biopsies, drainages of musculoskeletal abscesses, facet and sacroiliac joint injection and radiofrequency thermal ablation of painful metastases or osteoid osteomas.

  17. Quantitative Proteomic Analysis of Optimal Cutting Temperature (OCT) Embedded Core-Needle Biopsy of Lung Cancer

    Science.gov (United States)

    Zhao, Xiaozheng; Huffman, Kenneth E.; Fujimoto, Junya; Canales, Jamie Rodriguez; Girard, Luc; Nie, Guangjun; Heymach, John V.; Wistuba, Igacio I.; Minna, John D.; Yu, Yonghao

    2017-10-01

    With recent advances in understanding the genomic underpinnings and oncogenic drivers of pathogenesis in different subtypes, it is increasingly clear that proper pretreatment diagnostics are essential for the choice of appropriate treatment options for non-small cell lung cancer (NSCLC). Tumor tissue preservation in optimal cutting temperature (OCT) compound is commonly used in the surgical suite. However, proteins recovered from OCT-embedded specimens pose a challenge for LC-MS/MS experiments, due to the large amounts of polymers present in OCT. Here we present a simple workflow for whole proteome analysis of OCT-embedded NSCLC tissue samples, which involves a simple trichloroacetic acid precipitation step. Comparisons of protein recovery between frozen versus OCT-embedded tissue showed excellent consistency with more than 9200 proteins identified. Using an isobaric labeling strategy, we quantified more than 5400 proteins in tumor versus normal OCT-embedded core needle biopsy samples. Gene ontology analysis indicated that a number of proliferative as well as squamous cell carcinoma (SqCC) marker proteins were overexpressed in the tumor, consistent with the patient's pathology based diagnosis of "poorly differentiated SqCC". Among the most downregulated proteins in the tumor sample, we noted a number of proteins with potential immunomodulatory functions. Finally, interrogation of the aberrantly expressed proteins using a candidate approach and cross-referencing with publicly available databases led to the identification of potential druggable targets in DNA replication and DNA damage repair pathways. We conclude that our approach allows LC-MS/MS proteomic analyses on OCT-embedded lung cancer specimens, opening the way to bring powerful proteomics into the clinic. [Figure not available: see fulltext.

  18. The rational use of fine needle aspiration biopsy (FNAB) in diagnosing thyroid nodules.

    Science.gov (United States)

    Sidoti, M; Marino, G; Resmini, E; Augeri, C; Cappi, C; Cavallero, D; Lagasio, C; Ceppa, P; Minuto, F; Giusti, M

    2006-06-01

    Fine needle aspiration biopsy (FNAB) plays a crucial role in the diagnosis of thyroid nodules and enables the number of surgical operations to be reduced. Theoretically, FNAB should be carried out on all nodules, though currently only those displaying certain characteristics are biopsied. Indeed, to perform FNAB on all nodules may be regarded as an excess of zeal. Therefore, it seems advisable that the endocrinologist should be able to confirm on the spot the necessity and utility of FNAB. We evaluated on a sample of 263 consecutive requests (209 female, 57 male; age 56.7+/-13.7 years) for FNAB in 2004: 1) the appropriateness of the investigation, 2) expected efficacy, 3) practical efficacy, 4) efficiency. FNAB was performed under echo-guidance in accordance with the standard technique. In 50%, 36%, 6%, 3%, 2% and 1% of cases, the echographic diagnosis was of MNG, UNG, pseudo-nodular lesion in ATD, lymph-node, neck cyst, suspected parathyroid lesion and tumefaction of the salivary glands, respectively. A pre-FNAB clinical risk score was assigned to each case on the basis of clinical and echographic data, with a maximum possible score of 11. The results of FNAB were subdivided into 5 categories according to the criteria of the BTA (Thy1-Thy5). After FNAB, a decisional category was assigned, ranging from ''observation'' to ''surgery''; this was subsequently (7-18 months) compared with the management strategy adopted by the attending physician. Information was gathered by means of telephone enquiry. 1) Appropriateness: on the basis of clinical and echographic findings, FNAB was not judged appropriate in 24% of cases because of either the lack of confirmation of a significant target (34%) or a low pre-FNAB risk score (range 0-2) (66%). The decisional category was ''observation'' in 87% of cases and ''further investigation'' in 13%. 2) Expected efficacy: FNAB was performed in 76% of cases. The biopsies (3%) performed on swollen lymph-nodes and extra-thyroid neck

  19. Is Needle Biopsy Clinically Useful in Preoperative Grading of Central Chondrosarcoma of the Pelvis and Long Bones?

    Science.gov (United States)

    Roitman, Pablo D; Farfalli, Germán L; Ayerza, Miguel A; Múscolo, D Luis; Milano, Federico E; Aponte-Tinao, Luis A

    2017-03-01

    Central chondrosarcoma of bone is graded on a scale of 1 to 3 according to histological criteria. Clinically, these tumors can be divided into low-grade (Grade 1) and high-grade (Grade 2, Grade 3, and dedifferentiated) chondrosarcomas. Although en bloc resection has been the most widely used treatment, it has become generally accepted that in selected patients with low-grade chondrosarcomas of long bones, curettage is safe and effective. This approach requires an accurate preoperative estimation of grade to avoid under- or overtreatment, but prior reports have indicated that both imaging and biopsy do not always give an accurate prediction of grade. (1) What is the concordance of image-guided needle preoperative biopsy and postoperative grading in central (intramedullary) chondrosarcomas of long bones, and how does this compare with the concordance of image-guided needle preoperative biopsy and postoperative grading in central pelvic chondrosarcomas? (2) What is the concordance of preoperative image-guided needle biopsy and postoperative findings in differentiating low-grade from high-grade central chondrosarcomas of long bones, and how does this compare with the concordance in central pelvic chondrosarcomas? Between 1997 and 2014, in our institution, we treated 126 patients for central chondrosarcomas located in long bones and the pelvis. Of these 126 cases, 41 were located in the pelvis and the remaining 85 cases were located in long bones. This study considers 39 (95%) and 40 (47%) of them, respectively. We included all cases in which histological information was complete regarding preoperative and postoperative tumor grading. We excluded all cases with incomplete data sets or nondiagnostic preoperative biopsies. To evaluate the needle biopsy accuracy, we compared the histological tumor grade, obtained from the preoperative biopsy, with the final histological grade obtained from the postoperative surgical specimen. The weighted and nonweighted kappa statistics

  20. PET/CT-guided interventions: Indications, advantages, disadvantages and the state of the art.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Koch, Guillaume; Tsoumakidou, Georgia; Caudrelier, Jean; Addeo, Pietro; Bachellier, Philippe; Namer, Izzie Jacques; Gangi, Afshin

    2018-02-01

    Positron emission tomography/computed tomography (PET/CT) represents an emerging imaging guidance modality that has been applied to successfully guide percutaneous procedures such as biopsies and tumour ablations. The aim of the present narrative review is to report the indications, advantages and disadvantages of PET/CT-guided procedures in the field of interventional oncology and to briefly describe the experience gained with this new emerging technique while performing biopsies and tumor ablations.

  1. Percutaneous needle aspiration biopsy (PCNA) of pulmonary lesions: evaluation of a reaspiration or a rebiopsy (second PCNA)

    International Nuclear Information System (INIS)

    Lee, In Jae; Kim, Dong Gyu; Jung, Ki Suck; Koh, Sung Hye; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul; Bae, Sang Hoon; Im, Hyoung June

    2008-01-01

    To evaluate the effectiveness of the reaspiration or rebiopsy of pulmonary lesions (second PCNA) in cases where the pathologic results are inconclusive upon initial percutaneous needle aspiration biopsy (PCNA). A total of 364 PCNA cases (350 initial PCNA, 14 second PCNA) were performed under CT or fluoroscopy guidance for all the 350 patients enrolled. The procedure was performed by either using an automated biopsy gun with a 20-G needle (298 cases) or a 20-G aspiration needle (66 cases). The pathologic agreement rates between the initial and second PCNA, as well as the causes for a second PCNA, were evaluated. Finally the type and rate of complication were also evaluated. The second PCNA rate was 4.0% (14/350). The causes for a second PCNA, following the initial PCNA included unexpected pathologic results (n = 7) and inconclusive pathologic results (n = 7). Of the seven cases which had unexpected pathologic results from their initial PCNAs, five had similar pathologic results after a second PCNA. Also, of the seven cases of inconclusive pathologic results, such as atypical cells, the scanty cellularity or necrosis upon an initial PCNA, six cases revealed a malignancy on a second PCNA. The overall complication rate, including both the initial and second PCNAs was 14.0% (51/364). A second PCNA was performed to help resolve the exact diagnosis for a pulmonary lesion in cases of inconclusive pathologic results upon an initial PCNA

  2. Percutaneous CT-guided treatment of osteoidosteomas: combination of drill biopsy and subsequent ethanol injection; Perkutane CT-gesteuerte Behandlung von Osteoidosteomen: kombiniertes Vorgehen mit einem Hohlbohrer und nachfolgender Aethanolinjektion

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Keulers, P. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Vorwerk, D. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Heller, K.D. [Orthopaedische Klinik, RWTH Aachen (Germany); Fuezesi, L. [Inst. fuer Pathologie, RWTH Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany)

    1995-03-01

    The purpose of this study was the clinical evaluation of a percutaneous treatment modality in patients with an osteoidosteoma. 6 patients with an osteoidosteoma of the upper (n=1) and lower (n=5) extremity which were confirmed on plain film radiographs and computed tomography underwent CT controlled drill biopsy of the nidus with subsequent injection of 96% ethanol into the biopsy channel to sclerose probably remaining remnants of the nidus. The procedure was started under local anaesthesia, but drilling of the nidus was carried out under a short general anaesthesia using ketamine. The intervention was successful in all patients. No postinterventional infection occurred and no recurrence was observed in any of the patients in a follow-up time between 0.5 and 2 years. (orig./MG) [Deutsch] Zielsetzung der Untersuchungen war die klinische Erprobung eines perkutanen Verfahrens zur Behandlung von Osteoidosteomen. Bei 6 Patienten mit einem nativradiologisch und computertomographisch nachgewiesenen Osteoidosteom im Bereich der oberen (n=1) und der unteren Extremitaet (n=5) wurde perkutan unter CT-Kontrolle der Nidus ausgebohrt und ueber den Bohrkanal 96%iger Alkohol nachinjiziert, um etwaige Nidusreste zu sklerosieren. Der Eingriff wurde in Lokalanaesthesie begonnen, die Ausbohrung des Nidus unter einer Ketanestkurznarkose durchgefuehrt. Das Vorgehen war bei allen Patienten erfolgreich. In keinem Fall wurde eine postinterventionelle Infektion beobachtet. Ueber den Nachbeobachtungszeitraum von 0,5 bis zu 2,5 Jahren trat bei keinem der Patienten ein Rezidiv auf. (orig./MG)

  3. Value of Artisanal Simulators to Teach Ultrasound-Guided Percutaneous Biopsy Using a Tru-Cut Needle for Veterinary and Medical Students

    Science.gov (United States)

    de Araújo Setin, Raíza; Fortes Cirimbelli, Carolina; Mazeto Ercolin, Anna Carolina; Pires, Sâmara Turbay; Disselli, Tamiris; Ferrarini Nunes Soares Hage, Maria Cristina

    2018-01-01

    The present study aimed to evaluate the applicability of artisanal simulators to teach veterinary and medical students the ultrasound-guided percutaneous biopsy using a tru-cut needle. The artisanal simulators consisted of bovine liver between two layers of commercially available grape gelatin. Students were paired, with one doing the biopsy and…

  4. Can We Predict Phyllodes Tumor among Fibroepithelial Lesions with Cellular Stroma Diagnosed at Breast Core Needle Biopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hae Kyoung; Ko, Kyung Hee; Rho, Ji Young [Dept. of Radiology, CHA University College of Medicine, Seoul (Korea, Republic of); Moon, Hee Jung; Kim, Eun Kyung; Kim, Min Jung; Park, Byeong Woo [Dept. of Radiology, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    To evaluate the surgical outcomes of fibroepithelial lesion with cellular stroma (FELCS) diagnosed at sonography guided core needle biopsy of breast masses, and to determine whether the clinical and imaging features of this lesion could predict the presence of a phyllodes tumor. We retrospectively reviewed the pathologic results of sonography guided core needle biopsy of solid breast masses. A total of 55 FELCS diagnosed with this procedure that underwent subsequent surgical excision were included in this study; their medical records and radiologic images were retrospectively reviewed. The results of the surgical excision revealed 22 (40%) phyllodes tumors and 33 (60%) non-phyllodes tumors: 30 (54.6%) fibroadenomas, 1 (1.8%) adenosis, 1 (1.8%) fibrocystic changes and 1 (1.8%) fibroadenomatous hyperplasia. Lesion size and patient age were significantly different between phyllodes tumors and nonphyllodes tumors groups (32.2 {+-} 14.07 mm/22.4 {+-} 13.64 mm, p=0.0078, 43.5 {+-} 11.60 years/36.5 {+-} 10.25 years, p=0.0207). Among the sonographic features, only cleft was significantly more visible in phyllodes tumors than in non-phyllodes tumors (n=14 (70%)/n=6 (30%), p=0.0016). The size of the lesions, the age of the patients, and the sonographic features of cleft were the significant helpful variables to predict phyllodes tumors among FELCS diagnosed at breast core biopsy.

  5. Can We Predict Phyllodes Tumor among Fibroepithelial Lesions with Cellular Stroma Diagnosed at Breast Core Needle Biopsy?

    International Nuclear Information System (INIS)

    Jung, Hae Kyoung; Ko, Kyung Hee; Rho, Ji Young; Moon, Hee Jung; Kim, Eun Kyung; Kim, Min Jung; Park, Byeong Woo

    2011-01-01

    To evaluate the surgical outcomes of fibroepithelial lesion with cellular stroma (FELCS) diagnosed at sonography guided core needle biopsy of breast masses, and to determine whether the clinical and imaging features of this lesion could predict the presence of a phyllodes tumor. We retrospectively reviewed the pathologic results of sonography guided core needle biopsy of solid breast masses. A total of 55 FELCS diagnosed with this procedure that underwent subsequent surgical excision were included in this study; their medical records and radiologic images were retrospectively reviewed. The results of the surgical excision revealed 22 (40%) phyllodes tumors and 33 (60%) non-phyllodes tumors: 30 (54.6%) fibroadenomas, 1 (1.8%) adenosis, 1 (1.8%) fibrocystic changes and 1 (1.8%) fibroadenomatous hyperplasia. Lesion size and patient age were significantly different between phyllodes tumors and nonphyllodes tumors groups (32.2 ± 14.07 mm/22.4 ± 13.64 mm, p=0.0078, 43.5 ± 11.60 years/36.5 ± 10.25 years, p=0.0207). Among the sonographic features, only cleft was significantly more visible in phyllodes tumors than in non-phyllodes tumors (n=14 (70%)/n=6 (30%), p=0.0016). The size of the lesions, the age of the patients, and the sonographic features of cleft were the significant helpful variables to predict phyllodes tumors among FELCS diagnosed at breast core biopsy.

  6. A randomised pilot study comparing 13 G vacuum-assisted biopsy and conventional 14 G core needle biopsy of axillary lymph nodes in women with breast cancer

    International Nuclear Information System (INIS)

    Maxwell, A.J.; Bundred, N.J.; Harvey, J.; Hunt, R.; Morris, J.; Lim, Y.Y.

    2016-01-01

    Aim: To compare the acceptability, safety, and feasibility of vacuum-assisted biopsy (VAB) and core needle biopsy (CNB) of axillary lymph nodes in women with breast cancer. Materials and methods: This parallel, non-blinded, randomised study was approved by the National Research Ethics Service. Following written informed consent, women with abnormal appearing axillary lymph nodes and radiologically malignant breast masses were randomised 1:1 to lymph node sampling under local anaesthetic with either 14 G CNB or 13 G VAB in a single UK centre. Primary outcomes were study uptake rate and patient willingness to undergo a repeat procedure if necessary. Procedure duration, immediate and post-procedure pain scores, diagnostic yield, complications, and surgical histopathology were recorded. Results: Ninety-five women were approached; 81 (85.3%) consented and were randomised. Forty underwent CNB; 40 underwent VAB; one was excluded. Median age was 57 years. The median procedure time was 2 minutes for both techniques. The median number of samples obtained was three for CNB and four for VAB. Median pain scores for the procedure and first 3 days were 1/10 and 1/10 for CNB and 1/10 and 2/10 for VAB (p=0.11 and 0.04). More women were prepared to undergo repeat CNB compared to VAB, but the difference was not significant (38/39 versus 33/39; p=0.11). Two patients developed a haematoma after VAB. One CNB and six VABs failed to yield adequate tissue (p=0.11), but the sensitivity was similar at 79% and 78%. Conclusion: Study uptake was high. Acceptability of the two procedures was similar, but VAB was associated with more post-procedure pain. The sensitivity appears to be similar. - Highlights: • Vacuum biopsy of axillary lymph nodes can be performed rapidly. • Post-procedure pain was slightly higher in women who underwent vacuum biopsy. • The inadequate yield rate of vacuum biopsy may be higher than that for core biopsy. • Sensitivity of 13-gauge vacuum biopsy and 14-gauge

  7. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature

    Directory of Open Access Journals (Sweden)

    Suvradeep Mitra

    2016-01-01

    Full Text Available In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC. Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist.

  8. A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Xu Chen; Hu, Xu Hua; Wang, Xiao Ran; Zhou, Chao Xi; Wang, Fei Fei; Yang, Shan; Wang, Gui Ying

    2018-03-16

    Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM). It is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method. Articles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library. Preset outcomes were abstracted and pooled to find out the potential advantages in CNB or VAB. Seven studies were identified and entered final meta-analysis from initially found 138 studies. The rate of ductal carcinoma in situ (DCIS) underestimation was significantly lower in VAB than CNB group [risk ratio (RR) = 1.83, 95% confidence interval (CI) 1.40 to 2.40, p < 0.001]. The microcalcification retrieval rate was significantly higher in VAB than CNB group (RR = 0.89, 95% CI 0.81 to 0.98, p = 0.02), while CNB owned a significantly lower complication rate than VAB (RR = 0.18, 95% CI 0.03 to 0.93, p = 0.04). The atypical ductal hyperplasia (ADH) underestimation rates were not compared for the limited number of studies reporting this outcome. Compared with CNB, VAB shows better diagnostic performance in DCIS underestimation rate and microcalcification retrieval rate. However, CNB shows a significantly lower complication rate. More studies are needed to verify these findings.

  9. Accuracy of HER2 status determination on breast core-needle biopsies (immunohistochemistry, FISH, CISH and SISH vs FISH).

    Science.gov (United States)

    Arnould, Laurent; Roger, Pascal; Macgrogan, Gaëtan; Chenard, Marie-Pierre; Balaton, André; Beauclair, Sophie; Penault-Llorca, Frederique

    2012-05-01

    Preoperative breast cancer diagnosis on core biopsies has become a standard of care in many countries. Controversies exist concerning the accuracy of HER2 testing on biopsies as compared with surgical specimens, and few data exist concerning the use of emerging technologies such as bright-field in-situ hybridization in such a setting. A French multicenter, cross-sectional, histopathological study assessed the concordance of HER2 status determined by immunohistochemistry and silver (SISH) or chromogenic in-situ hybridization (CISH) on core-needle biopsies with HER2 status determined by fluorescence in-situ hybridization (FISH) on surgical specimens. The concordance between biopsy and operative results was also assessed for each method. We studied 260 breast tumors from 24 centers between April 2003 and August 2009. Excellent concordance (κ: 0.92-0.97) was shown between immunohistochemistry and FISH with low discordance rates (2-4%), high specificity (97-98%) and sensitivity values (95-99%), with no significant difference according to the immunohistochemistry interpretation guidelines used. The correlation between SISH and CISH on biopsies and FISH on surgical samples was strong (κ: 0.96 and 0.94, respectively), with no significant difference between false negative rates or sensitivity and specificity values (2 and 5%, 99 and 96%, 98 and 98%, respectively). Whatever the evaluation technique, excellent concordance between biopsies and surgical specimens was observed (κ ≥ 0.97; discordance rates between 1 and 2%), with high sensitivity (98-99%) and specificity (98-100%). Based on these results, when FISH cannot be used, SISH and/or CISH could be proposed as an alternative method to determine HER2 status and to confirm any ambiguous immunohistochemistry results, either for preoperative percutaneous biopsies or for surgical specimens. They could also be used for quality controls and immunohistochemistry calibration.

  10. Indications for diagnostic open biopsy of mammographic screen-detected lesions preoperatively diagnosed as fibroadenomas by needle biopsy and their outcomes

    International Nuclear Information System (INIS)

    Sala, M.A.; Dhillon, R.; Brookes, D.; Lagrange, C.; Metcalf, C.; Wylie, E.

    2015-01-01

    Aim: To identify the clinical, radiological, and histopathological factors that resulted in a diagnostic open biopsy of mammographic screen-detected lesions diagnosed preoperatively as fibroadenomas by needle biopsy. Materials and methods: BreastScreen WA data over 10 year period from 1 January 1999 to 31 December 2008 was reviewed. Results: Among the 760,027 women screened in Western Australia between 1999 and 2008, 31 had a fine-needle aspiration (FNA) or a core biopsy (CB) diagnosing a fibroadenoma and subsequently underwent a diagnostic open biopsy (DOB). Three were preoperatively diagnosed as fibroadenoma by initial FNA but subsequent CB showed that these were not fibroadenomas and, therefore, were excluded from the present series. Of the 28 cases, DOB identified 21 fibroadenomas, two cellular fibroadenomas, two benign phyllodes tumours, one malignant phyllodes tumour, one fibroadenoma containing ductal carcinoma in situ (DCIS), and one case of a 40 mm adenosis tumour with a small 5 mm fibroadenoma. The lesions ranged from 5–100 mm in size with an average size of 28 mm. DOB and CB results were concordant in 25 (89%) of the cases. The primary clinical indications for undergoing DOB included indeterminate histopathological findings of cellular fibroadenomas versus phyllodes tumour (n = 10), enlarging size (n = 4), large size (n = 5), fibroadenomas with atypia (n = 1), discordant radiological and pathological findings (n = 3), patient preference (n = 1), association with a second screen-detected lesion requiring excision (n = 2), and an unknown indication (n = 1). Conclusion: CB diagnosis of fibroadenomas is a safe diagnosis unless it has atypical clinical, radiological, or pathological features. - Highlights: • The aim was to identify factors that lead to excision of benign fibroadenomas. • Screen detected fibroadenomas must be adequately sampled to exclude malignancy. • Large, enlarging, cellular or atypical lesions should undergo

  11. Practical guidelines for ultrasound-guided core needle biopsy of soft-tissue lesions: Transformation from beginner to specialist

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Yoon; Chung, Hye Won; Oh, Tack Sun; Lee, Jong Seok [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-04-15

    Ultrasound-guided core needle biopsy (US-CNB) is an important step in the diagnosis of musculoskeletal soft-tissue lesions. To maximize efficacy and minimize the complications of US-CNB, it is critical to collaborate with a multidisciplinary team and to understand the particular considerations of US-CNB for these lesions. The purpose of this article is to provide a systematic review and step-by-step tips for using US-CNB to diagnose musculoskeletal soft-tissue lesions.

  12. A Randomised Clinical Trial to Compare Coaxial and Noncoaxial Techniques in Percutaneous Core Needle Biopsy of Renal Parenchyma

    International Nuclear Information System (INIS)

    Babaei Jandaghi, Ali; Lebady, Mohammadkazem; Zamani, Athar-Alsadat; Heidarzadeh, Abtin; Monfared, Ali; Pourghorban, Ramin

    2017-01-01

    PurposeTo compare the coaxial and noncoaxial techniques of renal parenchymal core needle biopsy.Materials and MethodsThis is an institutional review board-approved randomised controlled trial comparing 83 patients (male, n = 49) who underwent renal parenchymal core biopsy with coaxial method and 83 patients (male, n = 40) with noncoaxial method. The rate of complications, the number of glomerular profiles, and the procedural time were evaluated in a comparison of the two methods. Correlation between the presence of renal parenchymal disease and the rate of complication was also evaluated.ResultsThe procedural time was significantly shorter in the coaxial technique (coaxial group, 5 ± 1 min; noncoaxial group, 14 ± 2 min; p < 0.001). The rates of complications for the coaxial method was significantly lower than the noncoaxial method (coaxial group, 10.8 %; noncoaxial group, 24.1 %; p = 0.025). There was no significant correlation between gender and the rate of complication. The number of glomerular profiles was significantly higher in patents who underwent renal biopsy with the coaxial method (coaxial group, 18.2 ± 9.1; noncoaxial group, 8.6 ± 5.5; p < 0.001). In the whole study population, the rate of complications was significantly higher in patients with a pathologic renal parenchyma compared to those with a normal parenchyma (19/71 vs. 10/95; p = 0.006).ConclusionsRenal parenchymal biopsy using a coaxial needle is a faster and safer method with a lower rate of complications.

  13. A Randomised Clinical Trial to Compare Coaxial and Noncoaxial Techniques in Percutaneous Core Needle Biopsy of Renal Parenchyma

    Energy Technology Data Exchange (ETDEWEB)

    Babaei Jandaghi, Ali [Guilan University of Medical Sciences, Department of Radiology, Poursina Hospital (Iran, Islamic Republic of); Lebady, Mohammadkazem; Zamani, Athar-Alsadat [Guilan University of Medical Sciences, Urology Research Center, Razi Hospital (Iran, Islamic Republic of); Heidarzadeh, Abtin [Guilan University of Medical Sciences, Department of Community Medicine (Iran, Islamic Republic of); Monfared, Ali [Guilan University of Medical Sciences, Urology Research Center, Razi Hospital (Iran, Islamic Republic of); Pourghorban, Ramin, E-mail: ramin-p2005@yahoo.com [Tehran University of Medical Sciences, Department of Radiology, Imam Khomeini Hospital Complex (Iran, Islamic Republic of)

    2017-01-15

    PurposeTo compare the coaxial and noncoaxial techniques of renal parenchymal core needle biopsy.Materials and MethodsThis is an institutional review board-approved randomised controlled trial comparing 83 patients (male, n = 49) who underwent renal parenchymal core biopsy with coaxial method and 83 patients (male, n = 40) with noncoaxial method. The rate of complications, the number of glomerular profiles, and the procedural time were evaluated in a comparison of the two methods. Correlation between the presence of renal parenchymal disease and the rate of complication was also evaluated.ResultsThe procedural time was significantly shorter in the coaxial technique (coaxial group, 5 ± 1 min; noncoaxial group, 14 ± 2 min; p < 0.001). The rates of complications for the coaxial method was significantly lower than the noncoaxial method (coaxial group, 10.8 %; noncoaxial group, 24.1 %; p = 0.025). There was no significant correlation between gender and the rate of complication. The number of glomerular profiles was significantly higher in patents who underwent renal biopsy with the coaxial method (coaxial group, 18.2 ± 9.1; noncoaxial group, 8.6 ± 5.5; p < 0.001). In the whole study population, the rate of complications was significantly higher in patients with a pathologic renal parenchyma compared to those with a normal parenchyma (19/71 vs. 10/95; p = 0.006).ConclusionsRenal parenchymal biopsy using a coaxial needle is a faster and safer method with a lower rate of complications.

  14. Advantages of stereotaxic needle biopsy of brain tumor using interventional magnetic resonance imaging. Report of 12 cases

    International Nuclear Information System (INIS)

    Terao, Tohru; Hashimoto, Takuo; Koyama, Tsutomu; Takahashi, Koichi; Harada, Junta; Abe, Toshiaki

    1998-01-01

    Interventional MRI, an advanced neuroimaging system, was used to perform stereotaxic needle biopsy of brain tissue (AIRIS, 0.3 Tesla, Hitachi) in 12 patients (9 males, 3 females) with intraparenchymal abnormal lesions. This system permits accurate and safe biopsy of brain tissue in real time. Patient ages ranged from 31 to 79 years (mean 61.5 years). We evaluated the abnormal lesion and dominant hemisphere of these patients preoperatively by using CT, MRI and cerebral angiography. Lesions were located in the left frontal lobe in 3 cases, the right frontal lobe in 1 case, the left temporal lobe in 1 case, the right temporal lobe in 1 case, the left parietal lobe in 2 cases, the right parietal lobe in 1 case, the left occipital lobe in 1 case, the bilateral basal ganglia in 1 case and the corpus callosum in 1 case. The sampling points were in the dominant hemisphere in 7 cases and in the non-dominant hemisphere in 5 cases. The diagnosis based on stereotaxic needle biopsy using this system were 4 gliomas, 1 brain abscess, 1 metastatic brain tumor, 1 granuloma, 2 cerebral infarctions, 2 malignant lymphomas and 1 normal brain tissue. Success rate of biopsy for our 12 cases using this system was 91.7%. Brain hemorrhage was a complication in 1 case but there was no case of meningitis or convulsion. This method is useful in patients with inoperable lesions, including deep lesion or lesions in the brainstem diencephalon or dominant hemisphere, in patients with serious complications, and in geriatric patients. In the future, this MRI system may be applied to minimally invasive therapies such as tumor ablation, cryosurgery, chemoablation, and ventrolateral thalamotomy for parkinsonism. (author)

  15. Bone marrow solid core biopsy needle: a critical assessment of the utility, benefits and limitations of the instruments employed in current day haematology and oncology.

    Science.gov (United States)

    Islam, Anwarul

    2018-06-01

    The optimal clinical evaluation of the bone marrow requires an examination of air-dried and well-stained films of the aspirated tissue along with a histopathological evaluation of adequately processed and properly stained core biopsy specimens. A bone marrow evaluation can be essential in establishing a diagnosis, determining the efficacy of treatment in haematological disorders and to monitor haematological status of patients following bone marrow/stem cell transplantation. It is also an essential component of the staging process for newly diagnosed malignancies. Currently available bone marrow aspiration needles are quite satisfactory and if properly used provide good-quality specimens for morphological evaluation. However, if a bone marrow core biopsy is concerned, several needles are currently in use but not all of them provide good-quality biopsy specimens for histological evaluation or are user friendly. We have compared the recently introduced Moeller Medical single use bone marrow core biopsy needle with the Jamshidi needle with marrow acquisition cradle (CareFusion), J-needle (Cardinal Health) and OnControl device (Vidacare). It is concluded that the Moeller Medical needle system has definite advantages over others and is recommended for routine use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Ultrasound guided pleural biopsy in undiagnosed exudative pleural effusion patients

    Directory of Open Access Journals (Sweden)

    Adel S. Ahmed

    2016-04-01

    In conclusion: Thoracic ultrasound (TUS guided pleural biopsy had a diagnostic yield which was slightly lower but comparable to both CT guided pleural biopsy and medical thoracoscopic pleural biopsy (MT.

  17. Fatal mediastinal biopsy: How interventional radiology saves the day

    Directory of Open Access Journals (Sweden)

    Y Yaacob

    2012-01-01

    Full Text Available This was a case of a 35-year-old man with mediastinal mass requiring computed tomography (CT-guided biopsy for tissue diagnosis. A posterior approach with an 18-gauge biopsy needle was used to obtain tissue sample. Post biopsy, patient condition deteriorated and multiphase CT study detected active bleeding in arterial phase at the biopsy site with massive hemothorax. Subsequent angiography showed arterial bleeder arising from the apical branch of the right pulmonary artery. Selective endovascular embolization with NBCA (n-Butyl cyanoacrylate was successful. Patient survived the complication. The case highlighted a rare complication in a common radiology procedure and the value of the interventional radiology unit in avoiding a fatal outcome.

  18. The clinical utility of multimodal MR image-guided needle biopsy in cerebral gliomas.

    Science.gov (United States)

    Yao, Chengjun; Lv, Shunzeng; Chen, Hong; Tang, Weijun; Guo, Jun; Zhuang, Dongxiao; Chrisochoides, Nikos; Wu, Jinsong; Mao, Ying; Zhou, Liangfu

    2016-01-01

    Our aim was to evaluate the diagnostic value of multimodal Magnetic Resonance (MR) Image in the stereotactic biopsy of cerebral gliomas, and investigate its implications. Twenty-four patients with cerebral gliomas underwent (1)H Magnetic Resonance Spectroscopy ((1)H-MRS)- and intraoperative Magnetic Resonance Imaging (iMRI)-supported stereotactic biopsy, and 23 patients underwent only the preoperative MRI-guided biopsy. The diagnostic yield, morbidity and mortality rates were analyzed. In addition, 20 patients underwent subsequent tumor resection, thus the diagnostic accuracy of the biopsy was further evaluated. The diagnostic accuracies of biopsies evaluated by tumor resection in the trial groups were better than control groups (92.3% and 42.9%, respectively, p = 0.031). The diagnostic yield in the trial groups was better than the control groups, but the difference was not statistically significant (100% and 82.6%, respectively, p = 0.05). The morbidity and mortality rates were similar in both groups. Multimodal MR image-guided glioma biopsy is practical and valuable. This technique can increase the diagnostic accuracy in the stereotactic biopsy of cerebral gliomas. Besides, it is likely to increase the diagnostic yield but requires further validation.

  19. C-arm cone-beam CT combined with a new electromagnetic navigation system for guidance of percutaneous needle biopsies. Initial clinical experience

    International Nuclear Information System (INIS)

    Kickuth, R.; Reichling, C.; Bley, T.; Hahn, D.; Ritter, C.

    2015-01-01

    To evaluate the feasibility and efficacy of C-arm fluoroscopic cone-beam computed tomography (CACT) in combination with a new electromagnetic tracking (EMT) system for needle guidance during percutaneous biopsies. 53 patients were referred for biopsy of thoracic (n = 19) and abdominal (n = 34) lesions. CT-like images of the anatomical region of interest (ROI) were generated using a flat panel-based angiographic system. These images were transmitted to an EMT system. A coaxial puncture needle with a sensor in its tip was connected with the navigation system and tracked into an electromagnetic field created via a field generator. Data generated within this field were merged with the CACT images. On a monitor both the anatomical ROI and needle tip position were displayed to enable precise needle insertion into the target. Through the coaxial needle, biopsy specimens for the histologic evaluation were extracted. Number of representative biopsy samples, number of core biopsies/patient, total procedure time, dose-area product, fluoroscopic time, and complications were recorded. 53 CACT/EMT-guided biopsy procedures were performed, 48 of which (91 %) yielded representative tissue samples. Four core biopsies were obtained from each patient. 40 (75 %) lesions were malignant and 13 (25 %) lesions were benign. The total procedure time was 9 ± 5 min (range, 3 - 23 min), fluoroscopic time was 0.8 ± 0.4 min (range, 0.4 - 2 min). The mean dose-area product (cGy cm 2 ) was 7373 (range, 895 - 26 904). The rate of complications (1 pneumothorax, 2 hemoptyses) was 6 %. CACT combined with EMT appears to be a feasible and effective technique for the guidance of percutaneous biopsies with a low rate of therapeutically relevant complications.

  20. C-arm cone-beam CT combined with a new electromagnetic navigation system for guidance of percutaneous needle biopsies. Initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kickuth, R.; Reichling, C.; Bley, T.; Hahn, D.; Ritter, C. [University Hospital of Wuerzburg (Germany). Inst. of Diagnostic and Interventional Radiology

    2015-07-15

    To evaluate the feasibility and efficacy of C-arm fluoroscopic cone-beam computed tomography (CACT) in combination with a new electromagnetic tracking (EMT) system for needle guidance during percutaneous biopsies. 53 patients were referred for biopsy of thoracic (n = 19) and abdominal (n = 34) lesions. CT-like images of the anatomical region of interest (ROI) were generated using a flat panel-based angiographic system. These images were transmitted to an EMT system. A coaxial puncture needle with a sensor in its tip was connected with the navigation system and tracked into an electromagnetic field created via a field generator. Data generated within this field were merged with the CACT images. On a monitor both the anatomical ROI and needle tip position were displayed to enable precise needle insertion into the target. Through the coaxial needle, biopsy specimens for the histologic evaluation were extracted. Number of representative biopsy samples, number of core biopsies/patient, total procedure time, dose-area product, fluoroscopic time, and complications were recorded. 53 CACT/EMT-guided biopsy procedures were performed, 48 of which (91 %) yielded representative tissue samples. Four core biopsies were obtained from each patient. 40 (75 %) lesions were malignant and 13 (25 %) lesions were benign. The total procedure time was 9 ± 5 min (range, 3 - 23 min), fluoroscopic time was 0.8 ± 0.4 min (range, 0.4 - 2 min). The mean dose-area product (cGy cm{sup 2}) was 7373 (range, 895 - 26 904). The rate of complications (1 pneumothorax, 2 hemoptyses) was 6 %. CACT combined with EMT appears to be a feasible and effective technique for the guidance of percutaneous biopsies with a low rate of therapeutically relevant complications.

  1. Fast 3-T MR-guided transrectal prostate biopsy using an in-room tablet device for needle guide alignment: a feasibility study.

    Science.gov (United States)

    Overduin, Christiaan G; Heidkamp, Jan; Rothgang, Eva; Barentsz, Jelle O; de Lange, Frank; Fütterer, Jurgen J

    2018-05-22

    To assess the feasibility of adding a tablet device inside the scanner room to assist needle-guide alignment during magnetic resonance (MR)-guided transrectal prostate biopsy. Twenty patients with one cancer-suspicious region (CSR) with PI-RADS score ≥ 4 on diagnostic multiparametric MRI were prospectively enrolled. Two orthogonal scan planes of an MR fluoroscopy sequence (~3 images/s) were aligned to the CSR and needle-guide pivoting point. Targeting was achieved by manipulating the needle-guide under MR fluoroscopy feedback on the in-room tablet device. Technical feasibility and targeting success were assessed. Complications and biopsy procedure times were also recorded. Needle-guide alignment with the in-room tablet device was technically successful in all patients and allowed sampling after a single alignment step in 19/20 (95%) CSRs (median size 14 mm, range: 4-45). Biopsy cores contained cancer in 18/20 patients. There were no per-procedural or post-biopsy complications. Using the tablet device, the mean time to first biopsy was 5.8 ± 1.0 min and the mean total procedure time was 23.7 ± 4.1 min. Use of an in-room tablet device to assist needle-guide alignment was feasible and safe during MR-guided transrectal prostate biopsy. Initial experience indicates potential for procedure time reduction. • Performing MR-guided prostate biopsy using an in-room tablet device is feasible. • CSRs could be sampled after a single alignment step in 19/20 patients. • The mean procedure time for biopsy with the tablet device was 23.7 min.